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Published on: October 26, 2019
Absorbable polydioxanone suture and results in total anomalous pulmonary venous connection
J A Hawkins1, L L Minich, L Y Tani
1Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, USA.
The Annals of Thoracic Surgery
|July 1, 1995
Summary
Absorbable polydioxanone suture significantly reduced late pulmonary venous obstruction after total anomalous pulmonary venous connection (TAPVC) repair compared to nonabsorbable polypropylene. This suggests absorbable sutures offer better long-term outcomes for TAPVC surgery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Surgical Innovation
Background:
- Theoretical benefits of absorbable sutures in growing vascular anastomoses are not well-documented for preventing late anastomotic stenosis in total anomalous pulmonary venous connection (TAPVC).
- Previous TAPVC repair strategies lacked clear evidence favoring absorbable over nonabsorbable sutures for long-term outcomes.
Purpose of the Study:
- To compare the incidence of late pulmonary venous obstruction and survival rates between absorbable polydioxanone and nonabsorbable polypropylene sutures in TAPVC repair.
- To evaluate the long-term efficacy of different suture materials in preventing vascular complications after TAPVC surgery.
Main Methods:
- A retrospective review of 65 hospital survivors of TAPVC repair from 1982 to 1994.
- Analysis of suture type used for the pulmonary venous-left atrial anastomosis: continuous nonabsorbable polypropylene (1982-1988) versus running absorbable polydioxanone (1989 onwards).
- Evaluation of late pulmonary venous obstruction using cardiac catheterization and echocardiography.
Main Results:
- Late pulmonary venous obstruction occurred in 3.2% of patients with polydioxanone sutures versus 17% with polypropylene sutures (p < 0.05).
- No obstruction was observed in the intracardiac TAPVC group (0/10).
- Actuarial 5-year freedom from obstruction was 96% for polydioxanone, 81% for polypropylene, and 100% for intracardiac TAPVC.
Conclusions:
- Continuous absorbable polydioxanone suture is associated with a lower incidence of late pulmonary venous obstruction and mortality in TAPVC repair.
- Absorbable sutures appear advantageous over nonabsorbable sutures, potentially by allowing better growth of the vascular anastomosis in low-pressure environments like TAPVC repair.
