HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mario Lachat Marko I. Turina Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by von Segesser, L. K. Articles by Turina, M. I. Search for Related Content PubMed PubMed Citation Articles by von Segesser, L. K. Articles by Turina, M. I. Related Collections Related Article

Ann Thorac Surg 1996;62:1045-1049
© 1996 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Improved Growth With Bioabsorbable Sutures in Both High- and Low-Pressure Zones

Clinic for Cardiovascular Surgery and Institute for Radiology, University Hospital, Zürich, Switzerland

Background. Compromised growth after operation remains a significant problem in the cardiovascular field. Some benefit of absorbable suture materials has been demonstrated for arterial anastomoses. However, for the low-pressure zone, few data are available.

Methods. To assess growth in high- versus low-pressure zones we transected the abdominal aorta (high- pressure zone) as well as the inferior vena cava (low-pressure zone) in 10 young mongrel dogs using for reanastomosis 7-0 nonabsorbable versus absorbable running sutures in random order.

Results. All animals survived and were evaluated over 12 months including body weight (gain, 212% ± 45% for nonabsorbable versus 218% ± 8% for absorbable; not significant), angiography, and, after elective sacrifice, detailed studies of aorta and vena cava. Systematic compilation of angiographic data at 12 months showed at the suture level an area of 13.8 mm² for nonabsorbable versus 24.3 ± 14.4 mm² for absorbable sutures in the high-pressure zone as compared with 12.9 ± 4.9 mm² for nonabsorbable versus 25.3 ± 15.4 mm² for absorbable sutures in the low-pressure zone. Residual lumen, calculated as a function of the area above and below the suture, accounted for 35% ± 10% for nonabsorbable versus 92% ± 12% for absorbable sutures (p < 0.001) in the high-pressure zone as compared with 37% ± 13% for nonabsorbable versus 75% ± 15% for absorbable sutures (p < 0.003) in the low-pressure zone (high versus low, not significant). Poststenotic dilatation accounted for 199% ± 22% for nonabsorbable versus 126% ± 43% for absorbable sutures (p < 0.01) in the high-pressure zone. In the low-pressure zone, poststenotic dilatation remained below the inflow area, and the residual poststenotic lumen accounted for 52% ± 14% for nonabsorbable versus 77% ± 16% for absorbable sutures (p < 0.004). Macroscopic, light, and scanning electron microscopic studies confirmed different growth patterns in high- versus low-pressure zones.

Conclusions. Aortic narrowing resulted in poststenotic dilatation and unrestricted outflow path (hourglass-type stenosis). Caval narrowing was followed by restriction of poststenotic outflow path (funnel-type stenosis). Absorbable suture material allows for superior growth in both high- and low-pressure zones.

Related Article

Discussion
Ann. Thorac. Surg. 1996 62: 1049-1050. [Extract] [Full Text]

This article has been cited by other articles:

				C. J. Barreiro, T. A. Ellison, J. A. Williams, M. L. Durr, D. E. Cameron, and L. A. Vricella Subclavian flap aortoplasty: still a safe, reproducible, and effective treatment for infant coarctation Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 649 - 653. [Abstract] [Full Text] [PDF]

				N. Yoshimura, M. Yamaguchi, H. Ohashi, Y. Oshima, Y. Toyoda, H.-N. Chung, and K. Ogawa Growth of the Subclavian Artery and the Anastomosis in Blalock-Taussig Shunt: Absorbable Versus Nonabsorbable Suture Ann. Thorac. Surg., June 1, 1998; 65(6): 1746 - 1750. [Abstract] [Full Text] [PDF]