Sutureless Prosthesis for Aortic Aneurysms

Abstract

To the Editor: In 1912, Alexis Carrel1Carrel A Results of the permanent intubation of the thoracic aorta.Surg Gynecol Obstet. 1912; 15: 245-248Google Scholar described a technique for permanent intubation of the thoracic aorta and suggested its use in treating thoracic aortic aneurysms. In 1952, Voorhees et al2Voorhees AB Jaretzki A Blakemore AH The use of tubes constructed from Vinyon “N” cloth and bridging arterial defects.Ann Surg. 1952; 135: 332-336Crossref PubMed Scopus (322) Google Scholar reported the use of Vinyon “N” cloth for bridging arterial defects. In several of their laboratory animals, Voorhees et al2Voorhees AB Jaretzki A Blakemore AH The use of tubes constructed from Vinyon “N” cloth and bridging arterial defects.Ann Surg. 1952; 135: 332-336Crossref PubMed Scopus (322) Google Scholar used a “nonsuture Vitallium cuff technique” described by Blakemore et al3Blakemore AH Lord JW Stefko PL The severed primary artery in the war wounded.Surgery. 1952; 18: 488-508Google Scholar in 1942. Since that time, there has been little interest in a sutureless technique for inserting arterial prostheses. Recently, we developed a prosthesis consisting of Dacron cloth with two cloth-covered stainless steel spools at either end for use in the treatment of thoracic aneurysms (Fig 1). We have now used this prosthesis in six patients, with no surgical deaths and no complications. Follow-up x-ray films and arteriograms have shown no tendency for thrombosis or migration of the prosthesis. The high surgical mortality in acute dissection of the aorta is primarily due to hemorrhage from attempts to suture friable edematous tissue. By utilizing a sutureless prosthesis, this complication is avoided. The prosthesis may be inserted with little difficulty and thus a short duration of cross-clamping of the aorta. We believe that this is a significant advance in the treatment of thoracic aneurysms, and we are preparing to submit a complete report on our work in the near future.