MECHANICS OF SPATULATED END-TO-END ARTERY-TO-VEIN ANASTOMOSES

It previously has been shown that in straight end-to-end artery-to-vei n anastomoses, maximum dimensions are obtained with an interrupted sut ure line. Nearly equivalent dimensions are obtained with a continuous compliant polybutester suture (Novafil), and the smallest dimensions a re obtained with a continuous noncompliant polypropylene suture (Surgi lene). The present study was undertaken to examine these suture techni ques in a spatulated or beveled anastomosis in living dogs. Anastomose s were constructed using continuous 6-0 polypropylene (Surgilene), con tinuous 6-0 polybutester (Novafil), or interrupted 6-0 polypropylene o r polybutester. Thirty minutes after construction, the artery, vein, a nd beveled anastomoses were excised, restored to in situ length and pr essurized with the lumen filled with a dilute suspension of barium sul fate. High resolution radiographs were obtained at 25 mmHg pressure in crements up to 200 mmHg. Dimensions and compliance were determined fro m the radiographic images. Results showed that, unlike straight artery -to-vein anastomoses, there were no differences in the dimensions or c ompliance of spatulated anastomoses with continuous Surgilene, continu ous Novafil, or interrupted suture techniques. Therefore a continuous suture technique is acceptable when constructing spatulated artery-to- vein anastomoses in patients.