Chemically fixed human umbilical cord vein grafts as arterial substitutes: potential and limits

In spite of reported successes, synthetic fabric grafts and microporous and plain synthetic conduits have proven unsuitable for aorto-coronary bypasses and showed weaknesses below the knee. Readily available and uniform diameter vascular substitutes with biological and mechanical properties comparable to human vessels would be of paramount interest. Following reported successes with chemically fixed human umbilical veins (HUV), we have attempted to develop smaller diameter blood conduits and have improved the currently prevalent techniques of fixation, preparation and storage to generate more convenient surgical products. In vitro assessment of the processed HUV demonstrated that the HUV can be easily processed to make an arterial substitute that can be preserved either in a liquid medium or as a dry product. However, the in vivo implantations in dogs led to disappointing results for liquid-preserved or albuminated veins. Critical-point dried grafts gave better results, unfortunately they do not heal and they can only degrade after implantation.