An alternative to synthetic aortic grafts using jejunum

Synthetic materials currently used for arterial grafts can provoke serious complications such as infection, rejection, and incomplete reendothelializa tion. Porcine small intestinal submucosa (SIS) allografts (homografts) may not share these disadvantages yet still may provide an effective graft alte rnative. This study was designed to provide additional information concerni ng the performance of this material when used as an allo-patch graft. A por cine model was selected to enable hemodynamic comparisons to the adult huma n physiology. Slaughterhouse small intestine was used to prepare the SIS gr aft material. A well-vascularized section of jejunum was resected, rinsed, and maintained in 0.9% NaCl solution containing 10% gentamicin. The graft w as prepared by removing the serosal layer, inverting the material, and disc arding the mucosal surface in a similar manner. The remaining submucosa and stratum compactum constituted the graft material and was subdivided into s izes from 1.5 to 3.0 cm(2) tacked to foil for manageability, and was return ed to the gentamicin solution. The surgery was initiated with a femoral art erial line in the anesthetized swine, followed by isolation and preparation of the infrarenal aorta for grafting. Cross-clamps were applied and a 1.0 x 1.5-cm section of aortic wall was resected. Two sides of allograft were f reed from the foil and sewn into the aorta. Then the remaining sides were r emoved from the foil and final graft placement was completed. The graft was harvested at postoperative day 28 and presented for microscopic examinatio n. Results confirmed that reendothelialization with neovascularization had occurred during this interval.