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Ann Thorac Surg 1984;37:404-411
© 1984 The Society of Thoracic Surgeons
Department of Thoracic and Cardiovascular Surgery, Department of Surgery, Hannover Medical School, Hannover, West Germany
Accepted for publication September 30, 1983.
* Address reprint requests to Prof. Dr. Borst, Klinik für Thorax-, Herz-und Gefässchirurgie, Medizinische Hochschule Hannover, Konstanty-Gutschow-Str 8, D-3000 Hannover 61, West Germany
Composite extracardiac conduits consisting of a low-porosity woven graft and a high-porosity knitted double-velour Dacron graft presealed with fibrin glue were implanted between the right ventricle and the pulmonary artery in 6 dogs under partial heparinization. Two grafts were explanted after 6 weeks, 2 after 12 weeks, and 2 after 6 months. The healing properties of both types of prosthesis were studied macroscopically, under light microscopy, and with scatter electron microscopy.
Spontaneous peeling of both the inner and outer capsules of the graft occurred in 3 of 6 woven prostheses during transection. In the remaining 3, peeling could be easily induced by blunt dissection; this was impossible in the knitted grafts. Microscopically, in a comparison of the different weaves after identical time intervals, the inner capsule was noticeably thicker in woven than in knitted grafts. Transtitial ingrowth of fibroblastic tissue could be observed in knitted grafts after 6 weeks; only poor transmural tissue bridging was detectable in woven prostheses after 6 months. Neovascularization of the inner capsule was detectable earlier and was more advanced toward the luminal surface of highly porous grafts.
In conclusion, knitted grafts in the position of extracardiac right ventricular conduits showed firmer attachment of both inner and outer capsules to the prosthetic material. Also, the inner capsule remained thinner and revealed a higher degree of neovascularization than in the woven Dacron grafts.
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