Influence of suture technique and suture material selection on the mechanics of end-to-end and end-to-side anastomoses

Experiments were performed in dogs to evaluate the mechanics of 26 end-to-end and 42 end-to-side artery-vein graft anastomoses constructed with continuous polypropylene sutures (Surgilene; Davis & Geck, Division of American Cyanamid Co., Danbury, Conn.), continuous polybutester sutures (Novafil;...

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Veröffentlicht in:The Journal of thoracic and cardiovascular surgery 1996-05, Vol.111 (5), p.1063-1072
Hauptverfasser: Baumgartner, Norbert, Dobrin, Philip B., Morasch, Mark, Dong, Quan-Sheng, Mrkvicka, Robert
Format: Artikel
Sprache:eng
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Zusammenfassung:Experiments were performed in dogs to evaluate the mechanics of 26 end-to-end and 42 end-to-side artery-vein graft anastomoses constructed with continuous polypropylene sutures (Surgilene; Davis & Geck, Division of American Cyanamid Co., Danbury, Conn.), continuous polybutester sutures (Novafil; Davis & Geck), and interrupted stitches with either suture material. After construction, the grafts and adjoining arteries were excised, mounted in vitro at in situ length, filled with a dilute barium sulfate suspension, and pressurized in 25 mm Hg steps up to 200 mm Hg. Radiographs were obtained at each pressure. The computed cross-sectional areas of the anastomoses were compared with those of the native arteries at corresponding pressures. Results showed that for the end-to-end anastomoses at 100 mm Hg the cross-sectional areas of the continuous Surgilene anastomoses were 70% of the native artery cross-sectional areas, the cross-sectional areas of the continuous Novafil anastomoses were 90% of the native artery cross-sectional areas, and the cross-sectional areas of the interrupted anastomoses were 107% of the native artery cross-sectional areas ( p < 0.05). At physiologic pressures, there were no differences in compliance among the three types of anastomosis. These data suggest that when constructing an end-to-end anastomosis in a small vessel, one should use an interrupted suture line or possibly continuous polybutester suture. Forty-two end-to-side anastomoses demonstrated no differences in cross-sectional areas or compliance for the three suture techniques. This suggests that, unlike with end-to-end anastomoses, when constructing an end-to-side anastomosis in patients any of the three suture techniques may be acceptable. (J T HORAC C ARDIOVASC S URG 1996;111:1063-72)
ISSN:0022-5223
1097-685X
DOI:10.1016/S0022-5223(96)70383-5