Del Campo C, Love J, Bowes F
Department of Surgery, Halifax Infirmary Hospital, Dalhousie University, NS.
Can J Surg. 1992 Jun;35(3):305-9.
Prosthetic replacement of the vena cava has been disappointing, mainly because of the hemodynamic characteristics of the venous system and the physical properties of the prostheses used. Spiral grafts constructed with autogenous saphenous vein have been the most successful prostheses to date, but their use is limited to replacement of short segments, and intraoperative construction is time consuming. The authors report their experience with a graft constructed of extra-thick bovine pericardium (PX) and surgical staples. Externally stented polytetrafluoroethylene (PTFE) was used as a control. The superior vena cava was replaced in 13 ewes; PTFE was used in 6 (group 1) and PX in 7 (group 2). Mean follow-up was 15 +/- 8 months for group 1 and 13 +/- 8 for group 2. Cumulative graft follow-up totalled 4612 graft-days. There was one graft occlusion in each group. Patency rates (80%) were similar for the two groups. Histologic changes in pericardial grafts were more marked but did not influence patency. This study reports the longest experimental follow-up (maximum 23 months) and graft patency to date for replacement of the superior vena cava. Both types of graft performed excellently.
腔静脉的人工置换一直不尽人意，主要是由于静脉系统的血流动力学特性以及所用假体的物理性能。自体大隐静脉构建的螺旋移植物是迄今为止最成功的假体，但它们的使用仅限于短节段的置换，并且术中构建耗时。作者报告了他们使用超厚牛心包（PX）和手术吻合钉构建移植物的经验。使用外部支撑的聚四氟乙烯（PTFE）作为对照。在13只母羊中进行了上腔静脉置换；6只使用PTFE（第1组），7只使用PX（第2组）。第1组的平均随访时间为15±8个月，第2组为13±8个月。移植物累计随访时间总计4612个移植物日。每组各有1例移植物闭塞。两组的通畅率（80%）相似。心包移植物的组织学变化更为明显，但不影响通畅率。本研究报告了迄今为止上腔静脉置换最长的实验随访时间（最长23个月）和移植物通畅率。两种类型的移植物表现都非常出色。
