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Ann Thorac Surg 2002;73:1692
© 2002 The Society of Thoracic Surgeons

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Correspondence

Replacement of the iliac vein: reply

^a Department of Cardiac Surgery, Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK

e-mail: satoyum{at}aol.com

To the Editor

My coauthors and I appreciate Dr Del Campo’s kind comments and are in agreement with his points. No uniform criteria have been established for standardized replacement of veins. We believe the method we described [1] could be an alternative to commercially available polytetrafluoroethylene grafts. We agree that homograft materials for iliac vein replacement are not always available in every institution. However, they could become more obtainable were they not discarded without consideration of future usage.

We agree that a bovine pericardial roll could be another alternative. As Dr Del Campo points out, however, there were no appropriate studies to compare these two methods. It would be impossible to discuss which would be more suitable in a given situation without reliable evidence. We all understand that one of the potential problems of these grafts is calcification, and an allogenic graft might be better than a xenogenic graft regarding calcification [2]. Again this is purely theoretical. We have extended our follow-up to 11 months and confirmed patency with no calcification. Without doubt, further data are needed before a firm recommendation can be made for any of the grafts and before uniform criteria can be established for the replacement of veins in acute and chronic situations.

References

1. Handa A., Saito S., Moorjani N., Westaby S. Iliac vein replacement with a descending aortic homograft. Ann Thorac Surg 2001;72:957-958.[Abstract/Free Full Text]
2. Dittrich S., Alexi-Meskishvili V.V., Yankah A.C., et al. Comparison of porcine xenografts and homografts for pulmonary valve replacement in children. Ann Thorac Surg 2000;70:717-722.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Satoshi Saito Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Saito, S. Search for Related Content PubMed Articles by Saito, S. Related Collections Peripheral vascular Related Article