Experimental replacement of the superior vena cava: autologous veins, free inverted jejunal grafts, and dacron grafts treated with graphite-benzalkonium-heparin.

Abstract

MANY reports are available describing the experimental replacement of the superior vena cava by various synthetic grafts. 1-4 Success rates vary, but as yet no really reliable material has been found. Thrombosis of grafts, both immediate and late, has been the main source of failure; and therefore, the frequency of this complication is the standard by which a new technique or material is judged. Autologous vein grafts have been the most successful superior caval grafts. 5 Thrombus-resistant grafts of Dacron treated with graphite-benzalkonium-heparin (GBH), according to the technique of Gott, have been used with some success. 6 Untreated Dacron grafts have been associated with high rates of thrombosis. 7 Inverted jejunal grafts have been reported to have a 100% success rate. 8 The experiments reported here constitute a comparative investigation of five different types of graft used for superior vena caval replacement. Long-term follow-up results are reported in all groups.