ABSORBABLE PDS-II SUTURE AND NONABSORBABLE POLYPROPYLENE SUTURE IN AORTIC ANASTOMOSES IN GROWING PIGLETS

The long-term outcome of vascular anastomoses in children can be compr omised by stenosis when the growth of the anastomosis does not match t hat of the vessels. This can be influenced by the suture material. We evaluated the suitability of the nea generation of polydioxanone (PDS- II), an absorbable synthetic monofilament suture, in vascular surgery, in terms of permitting normal growth of aortic anastomoses. Ten pigle ts underwent primary end-to-end anastomosis of the thoracic aorta, fiv e with PDS-II suture and five with conventional polypropylene (Prolene ) suture. Six months after surgery, an aortogram was obtained for each animal. The piglets were then killed and the aortas were sent for pat hologic examination. Complete absorption of suture material with sligh t dilatation of the anastomoses was found in all five pigs in the PDS- II suture group. We also found thrombus formation in one pig in this g roup. Mild stenosis of the anastomotic site was noted in all five pigs in the polypropylene suture group, but no intraluminal thrombus forma tion was seen. The degree of dilatation or stenosis within each group was not significantly different when intraluminal diameters were compa red at three distinct sites in the reconstructed aorta (I? > 0.05). Th e differences in vascular growth between the two groups were also not significant (p > 0.05). Histologic examination revealed less tissue re action in the PDS-II suture group than in the polypropylene suture gro up. Thus, PDS-II seems to be a suitable suture material for anastomose s as far as vascular growth is concerned, but the possibility of aneur ysm formation secondary to dilatation of the anastomotic site should b e kept in mind.