CLINICAL-EXPERIENCE WITH A COLLAGEN IMPREGNATED WOVEN DACRON GRAFT

Vascular grafts continue to evolve. Recent developments have been aime d at decreasing porosity, increasing strength of prosthesis, increasin g ease of handling and suturing and optimising flow characteristics. T his study describes results with a recently developed collagen impregn ated polyester prosthesis Hemashield Woven Double Velour, which does n ot require pre-clotting, Between January 1988 and December, 1991 such prostheses were used in 90 patients at Papworth Hospital, Fifty-eight, were used to replace the ascending aorta, 10 for the arch of the aort a and 28 for the descending aorta seven of whom were for coarctation a nd four for traumatic transections. In 60 cases the underlying disease was a dissected or ruptured aorta requiring emergency operation. Ther e were 66 survivors with X-ray and CT follow-up of 6-52 months. Median blood loss was 630 ml range 380-1800 ml. There was no leakage from an y of the grafts during surgery despite full perioperative heparinisati on. For emergency/elective operations (N=60/30) early mortality was 25 %/10% (15/3) and late mortality 5%/6.6% (3/2) Of 15 patients who had i nterposition grafts for Type A dissection CT scans at 5-47 months show ed one with chronic dissection proximal to the repair and 11 with pers istent distal dissection. There was no evidence of late bleeding, sero ma impaired healing or thickened neointima formation. It is concluded that there are no clinical disadvantages associated with collagen impr egnation to set against the notable convenience of initial impermeabil ity.