Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan.
Ann Thorac Surg. 2011 Mar;91(3):899-902. doi: 10.1016/j.athoracsur.2010.11.030.
A new vascular graft (Triplex [Vascutek Terumo, Tokyo, Japan]) has a three-layer structure and no biologic coating material. We assessed inflammatory reaction and mediastinal tube drainage after thoracic aortic surgery using this graft.
Between January 2009 and September 2009, 127 patients underwent open ascending aortic or arch repair. Triplex grafts (Vascutek Terumo) were used in 39 patients. After matching surgical procedures, 35 matched pairs (35 with Triplex, group A; 35 with coated graft, group B) were created. We compared postoperative inflammatory markers, amount, and duration of mediastinal drainage between the two groups.
There was no difference in postoperative inflammatory marker levels between the two groups. The median total amounts of mediastinal drainage were 690 mL (group A) and 1,500 mL (group B) (p < 0.001). The median durations of drainage were 67 and 128 hours, respectively (p < 0.001). Multivariate linear regression analyses showed that use of the Triplex graft is an independent predictor of the small amount and short duration of mediastinal drainage.
Triplex grafts reduce the amount and duration of mediastinal drainage after thoracic aortic surgery, which may promote early ambulation and fast postoperative recovery.
一种新型血管移植物（Triplex[Vascutek Terumo，东京，日本]）具有三层结构，没有生物涂层材料。我们使用这种移植物评估了胸主动脉手术后的炎症反应和纵隔引流情况。
2009 年 1 月至 2009 年 9 月期间，127 例患者接受了升主动脉或弓部开放修复手术。39 例患者使用了 Triplex 移植物（Vascutek Terumo）。在匹配手术程序后，创建了 35 对匹配患者（35 例使用 Triplex，A 组；35 例使用涂层移植物，B 组）。我们比较了两组之间术后炎症标志物、纵隔引流总量和持续时间。
两组患者术后炎症标志物水平无差异。纵隔引流总量中位数分别为 690 毫升（A 组）和 1500 毫升（B 组）（p<0.001）。引流持续时间中位数分别为 67 小时和 128 小时（p<0.001）。多变量线性回归分析表明，使用 Triplex 移植物是纵隔引流总量小和持续时间短的独立预测因素。
Triplex 移植物可减少胸主动脉手术后纵隔引流的总量和持续时间，可能促进早期活动和快速术后恢复。
