Absorbable PDS-II suture and nonabsorbable polypropylene suture in aortic anastomoses in growing piglets

The long-term outcome of vascular anastomoses in children can be compromised by stenosis when the growth of the anastomosis does not match that of the vessels. This can be influenced by the suture material. We evaluated the suitability of the new generation of polydioxanone (PDS-II), an absorbable synthetic monofilament suture, in vascular surgery, in terms of permitting normal growth of aortic anastomoses. Ten piglets underwent primary end-to-end anastomosis of the thoracic aorta, five with PDS-II suture and five with conventional polypropylene (Prolene) suture. Six months after surgery, an aortogram was obtained for each animal. The piglets were then killed and the aortas were sent for pathologic examination. Complete absorption of suture material with slight dilatation of the anastomoses was found in all five pigs in the PDS-II suture group. We also found thrombus formation in one pig in this group. Mild stenosis of the anastomotic site was noted in all five pigs in the polypropylene suture group, but no intraluminal thrombus formation was seen. The degree of dilatation or stenosis within each group was not significantly different when intraluminal diameters were compared at three distinct sites in the reconstructed aorta (p > 0.05). The differences in vascular growth between the two groups were also not significant (p > 0.05). Histologic examination revealed less tissue reaction in the PDS-II suture group than in the polypropylene suture group. Thus, PDS-II seems to be a suitable suture material for anastomoses as far as vascular growth is concerned, but the possibility of aneurysm formation secondary to dilatation of the anastomotic site should be kept in mind.