REPLACEMENT OF THE THORACIC AORTA WITH COLLAGEN-IMPREGNATED WOVEN DACRON GRAFTS - EARLY RESULTS

We used the collagen-impregnated woven double-velour Dacron graft in 1 20 patients undergoing 122 aortic reconstructions. Seventy-nine aortic root, ascending, or arch replacements were performed during cardiopul monary bypass with or without circulatory arrest; 53 of the 79 were fo r acute aortic dissection. In addition, three infants and one child un derwent repair of truncus arteriosus. There were no deaths caused by h emorrhage or bleeding-related complications. For aortic root replaceme nt, the impervious nature of the collagen-impregnated woven double vel our Dacron graft allowed elimination of wraparound techniques. Eight d eaths occurred as a result of multisystem organ failure, which followe d late diagnosis of type A dissection. Two patients underwent reoperat ion for late complications of type A dissection. Thirty-nine patients underwent treatment for disease of the descending aorta; eight of thes e patients underwent a central cannulation technique with profound hyp othermic cardiopulmonary bypass. The other 31 underwent repair with ao rtic crossclamping without bypass. Four of these patients died: two as a result of multisystem organ failure, one as a result of uncontrolle d bleeding from the native dissected aorta, and one as a result of int estinal necrosis. Follow-up studies for 2 months to 5 years revealed t hree late deaths caused by the rupture of a persistent aneurysmal fals e lumen after type A dissection. The intraoperative advantages of the collagen-impregnated woven double velour Dacron graft represent an imp ortant advance in vascular graft technology. Its handling and suturing characteristics are excellent, and the graft is completely impervious in its originally manufactured state. Needle holes self-seal rapidly. Medium-term follow-up by clinical, angiographic, computed tomographic , and magnetic resonance imaging techniques showed no late graft compl ications-specifically, no dilatation or thrombus formation.