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[Teflon mandril method for pre-clotting a highly porous small-caliber fabric prosthesis]
Y Tomizawa1, Y Noishiki, T Okoshi
1Department of Cardiovascular Surgery, Tokyo Women's Medical College.
Abstract:
Healing characteristics in a highly porous fabric prosthesis are better than in a porous low one. However, bleeding from the highly porous graft wall after implantation has been a very big problem for surgeons, preventing them from using this prosthesis. When a small-caliber graft is pre-clotted and implanted, the condition of the inner surface, such as smoothness, enhances patency and anti-thrombogenicity. We developed a method for pre-clotting a highly porous small-caliber fabric prosthesis using Teflon Mandril. Before pre-clotting, a fabric vascular prosthesis was held end-to-end and stretched to make the crimp shallow. Teflon stick, which outer diameter was 0.5 mm smaller than the graft, was used to pre-clot. Fresh blood was poured into the space between the stick and the vascular graft. After 3 to 5 minutes, when the blood coagulated, the vascular graft with the stick inside was squeezed with a dry towel. Care was taken not to peel the fibrin attached to the graft. With this method, a smooth and tight fibrin meshwork was obtained at the inner surface. This procedure was repeated five times. As a control, pre-clotting was induced according to Yate's method using the same fabric prosthesis. Two groups of pre-clotted grafts were examined macroscopically and in a perfusion model. Macroscopically, the inside of the graft in the developed method was smooth and without thrombus. On the other hand, in the control grafts, the fibrin meshwork was observed and thrombus at the crimp was noticed.(ABSTRACT TRUNCATED AT 250 WORDS)