The Journal of Thoracic and Cardiovascular Surgery, Vol 88, 253-258, Copyright © 1984 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
The effect of preclotting on surface thrombogenicity and thromboembolic complications of Dacron grafts in the canine thoracic aorta
P Gloviczki, LH Hollier, EA Hoffman, G Plate, VF Trastek and MP Kaye
Previous reports have advocated preclotting and autoclaving of Dacron
grafts to prevent graft hemorrhage, yet no data delineate possible changes
in surface thrombogenicity or thromboembolic risks. To assess these
factors, preclotted and preclotted-autoclaved woven Dacron prostheses were
implanted in the thoracic aorta of 31 dogs. Grafts were harvested 1 week to
1 month following implantation, and the thrombus- free surface of each
graft was calculated by computerized morphometry. Values for thrombus-free
surface were lowest in autoclaved grafts preclotted in nonheparinized blood
(72%) or in heparinized blood (78%). Grafts preclotted in platelet-rich
plasma and autoclaved had a thrombus- free surface value of 85%. Regular
preclotted grafts or grafts without preclotting had the greatest
thrombus-free surface value (97% and 99%). Distal embolization to the
kidneys was detected in seven of 31 animals (23%). No emboli were found in
animals with grafts that were not preclotted or if grafts were preclotted
with platelet-rich plasma and autoclaved. Thrombus-free surface values were
lower (p less than 0.01) in grafts with embolic complications (71% versus
91%). These data suggest that, if the risk of severe bleeding in fully
heparinized patients precludes the use of a woven Dacron graft without
preclotting, autoclaving a graft preclotted with platelet-rich plasma
appears to be the method of choice.
