The use of biocompound-grafts together with varicose veins. First clinical experience

Complete revascularisation of patients with multivessel disease and inadequate veins is unsatisfactory despite the more frequent use of different arterial conduits. The lack of an accurate vascular prosthesis in coronary artery surgery forces to use in a certain number of patients varicose or ectatic veins. In these cases, an ultraflexible metal mesh tube is placed intraoperatively with the aid of an application set outside the harvested vein and the two joined with fibrin glue (=biocompound-graft). It reduces the graft diameter and improves the hemodynamic properties of the graft. In 18 patients with no alternative graft, 43 biocompound-bypasses were implanted. The total number of implanted bypasses is 58 (mean 3.2+/-1.0). At hospital dismission 41 of 43 biocompound-bypasses are open. One patient died 2 months after the operation. At follow-up (3.9+/-4.0 months), 16 patients are at NYHA stage I or II, one patient at stage III. The first angiographic control in one patient shows all bypasses patent. First analysis of the results encourages continuous use of the biocompound-graft. The biocompound-graft offers the surgeon the possibility of using varicose-ectatic veins if alternative bypasses are not available. Moreover, there is experimental evidence of reduced intimal hyperplasia when mechanical unloading of the vein-wall tension is performed.