A VASCULAR PROSTHESIS SEALED WITH AUTOLOGOUS ADIPOSE TISSUE FRAGMENTS INSTEAD OF PRECLOTTING BY FRESH BLOOD

Abstract

A highly porous fabric vascular prosthesis sealed with autologous adipose tissue fragments into the wall was evaluated in an animal study. A piece of subcutaneous adipose connective tissue approximately weighing 2g was minced with scissors and stirred into 20ml of saline, thereby creating a tissue suspension. A fabric vascular prosthesis was turned inside out. The suspension was poured into the closed prosthesis by repeated pressurized injections using a syringe. Then, the prosthesis was turned inside out again. Consequently, the tissue fragments were squeezed into the prosthesis wall and sealed all the pores of the prosthesis. The treated grafts were implanted into the thoracic descending aortae of 24 mongrel dogs. No bleeding was noticed with the graft during and after implantation. Neointima with complete endotheloalozation was observed in all the grafts implanted for more than 30 days. Twenty-four preclotted prostheses were used as the control. Although the chest wall was closed after confieming that the bleeding from the suture line and through the prosthesis had stopped, problems occurred after surgery in the control grafts. Five out of 24 control animals (21%) bled in the pleural cavity and died within 24 hours after implantation. Neointima formation in the control grafts was limited near anastomotic sites in all cases up to 39 days of obserzation period. These results indicated that the sealing method was an ideal procedure of fabric vascular prostheses for cardiac wall substitutes. The results from an animal experiment could be expected in human if the property of the adipose tissue from human has a similar ability.