Development of a vascular prosthesis for a growing child. A graft expandable in vivo

Specially designed vascular prostheses that can be dilated after implantation using a percutaneous transluminal angioplasty (PTA) balloon catheter have been developed. The grafts are made of woven polyester fiber fabrics, the circumferential yarns of which consist of two different types of polyester fiber bundles: One is a straight weak bundle, the other is a strong bundle wound around the former. The graft with an initial diameter of 6 mm could be dilated to 9 mm by luminal inflation of the balloon four to five times at 10 atmospheres (atm) in vitro. After disrupting the weak bundle by the dilatation procedure, the strong bundles were straightened, which maintained the enlarged diameter of the new caliber. Grafts of 6 mm in initial diameter implanted into the thoracic aortas of mongrel dogs for 3 months also could be dilated in vivo by inflating the PTA four to five times at 15 atm, as found in the vitro study. Macroscopic observation revealed that, around the dilated grafts, only a tiny hematoma was formed and nominal subsequent bleeding was observed, which indicated that the dilatation procedure was performed safely. The graft, which enables adaptation of the hydrodynamic property of the graft to the increased blood flow by PTA after implantation, is applicable in a growing child.