DO COLLAGEN-IMPREGNATE KNITTED DACRON GRAFTS REDUCE THE NEED FOR TRANSFUSION IN INFRARENAL AORTIC RECONSTRUCTION

The purpose of this study was to evaluate the benefits of collagen-imp regnated Dacron grafts in patients undergoing infrarenal aortic recons truction. We therefore prospectively compared two consecutive series o f patients undergoing infrarenal aortic reconstruction with Dacron gra fts between January 1991 and December 1992. The first group (group A) included 83 high-density knitted prosthetic grafts (Dialine I), wherea s the second included 82 grafts of the same type but impregnated with collagen (Dialine II). The two groups were comparable with regard to a ge, sex, and operative risk factors. They were also comparable in term s of the proportion of patients with occlusive disease or aneurysms, t hat is, there were 39 and 36 patients with occlusive disease and 44 an d 46 patients with aneurysms in groups A and B, respectively. The type of bypass was similar in both groups with 17 and 19 tubular grafts an d 66 and 63 bifurcated grafts being inserted in groups A and B, respec tively. Thirteen parameters were studied and compared within each grou p including (1) number of infected grafts, (2) number of postoperative occlusions, (3) maximum postoperative temperature, (4) number of posi tive postoperative blood cultures, (5) number of postoperative deaths, (6) intraoperative and (7) postoperative quantities of blood transfus ed, (8) difference between pre- and postoperative hemoglobin concentra tions, (9) difference between pre- and postoperative fibrinogen levels , (10) difference between pre- and postoperative platelet counts, (11) duration of aortic clamping, (12) date of return of intestinal functi on, and (13) mean duration of pre- and postoperative hospital stays. O ne death, one graft occlusion, and one postoperative infection were ob served in group A, whereas there were three deaths, two occlusions, an d one postoperative infection in group B (difference not significant). Of all the parameters studied, the only significant difference concer ned the reduction in transfusion requirements of units when a collagen -impregnated graft was inserted (p < 0.05). These results are similar to those observed with other standard or collagen-coated knitted graft s. Less loss of blood, resulting in a reduced theoretic risk of viral contamination, appears to be the main advantage of collagen-coated gra fts.