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Aortic replacement with sutureless intraluminal grafts.

G M Lemole1

  • 1The Department of Cardiovascular Surgery, Medical Center of Delaware, Newark, Delaware 19713, USA.

Texas Heart Institute Journal
|January 1, 1990
PubMed
Summary

Sutureless intraluminal grafts offer a safe alternative to traditional aortic repair, reducing complications and cross-clamp times. These grafts demonstrate favorable early and late outcomes across various aortic regions.

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Surgical Innovation

Background:

  • Standard suture repair of aortic lesions is associated with anastomotic complications and prolonged aortic cross-clamp times.
  • Minimizing operative time and complications is crucial for improving patient outcomes in aortic surgery.

Purpose of the Study:

  • To evaluate the safety and efficacy of sutureless intraluminal grafts for aortic lesions.
  • To compare the outcomes of sutureless grafts with traditional suture repair methods.

Main Methods:

  • Implantation of sutureless intraluminal grafts in 122 patients with various aortic disorders since 1976.
  • Analysis of operative mortality, 5-year actuarial survival rates, and specific complication rates (e.g., graft dislodgement, infection, bleeding, pseudoaneurysm).

Main Results:

  • Ascending aorta/arch (49 patients): 14% operative mortality, 64% 5-year survival; no graft dislodgement, infection, bleeding, or pseudoaneurysm.
  • Descending/thoracoabdominal aorta (42 patients): 10% early mortality, 56% 5-year survival; one graft dislodgement, no pseudoaneurysm, erosion, bleeding, hemolysis, or permanent deficits.
  • Abdominal aorta (31 patients): 6% early mortality, 79% 5-year survival; no renal failure, ischemic complications, paraplegia, pseudoaneurysm, or anastomotic aneurysm.

Conclusions:

  • Sutureless intraluminal grafts provide shorter cross-clamp times and fewer intraoperative complications compared to traditional methods.
  • The early and late results of sutureless grafts are comparable to those of traditional aortic repair techniques.
  • Ongoing development aims to enhance graft adaptability for wider application in complex aortic anatomies.

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