Clinical experience with a new collagen-coated Dacron double-velour prosthesis

Vascular grafts with primary zero porosity are desirable in surgery for aortic aneurysms with intraoperative partial or total systemic heparinization of the patient. The present study describes the clinical application and results of a new knitted Dacron double-velour prosthesis (primary porosity: 1,400 cc/min/cm2), coated with cross-linked bovine collagen; the resulting porosity for implantation is O cc/min/cm2. Such grafts were implanted in 111 patients between 12/83 and 11/84: for replacement of the infrarenal aorta in 74 aneurysms, for replacement of the thoraco-abdominal aorta in 4 instances, and for replacement of 13 aneurysms of the descending aorta. In 20 patients with arterial occlusive disease, the prosthesis was employed as bifurcation graft. In 43 cases (38%) the underlying disease was a ruptured (26) or symptomatic aortic aneurysm requiring emergency operation. There was no leakage from any of the implanted grafts regardless of whether partial (100 units/kg BW) or total (300 units/kg BW) systemic heparinization was administered. The overall mortality rate was 11.7% (13/111). For cases of ruptured abdominal aortic aneurysm the mortality rate was 22.7% (5/22). There was no graft-related complication either in the early postoperative course or during the follow-up period (1 to 10 months, mean: 6.2 months). It is concluded that this new type of graft combines the advantages of knitted Dacron prostheses in respect to healing and incorporation with primary zero porosity, and is therefore the graft of choice in surgery for ruptured aortic aneurysm.