Jonas R A, Mayer J E, Castaneda A R
Department of Cardiac Surgery, Children's Hospital, Boston, MA 02115.
J Card Surg. 1987 Jun;2(2):257-64. doi: 10.1111/j.1540-8191.1987.tb00181.x.
A clinical trial of a collagen-sealed knitted Dacron conduit (Tascon Medical Technologies) in 86 patients has revealed a high incidence of early reoperation for conduit stenosis. At 3 years, the actuarial incidence of freedom from conduit replacement was 67 +/- 14% for valved conduits, and 66 +/- 20% for nonvalved conduits. Seven of eight conduits that were replaced had a thick, weakly adherent pseudointima. Comparison of the current series with a previous series of patients receiving tightly woven low-porosity Dacron conduits is complicated by the young age, small size, and greater complexity of the current group. Nevertheless, the findings are consistent with the results of two laboratory studies performed at this hospital which suggest that the collagen used in the Tascon conduit undergoes particularly slow resorption, resulting in weak adhesion between the pseudointima and conduit. This allows hemorrhagic dissection to occur deep to the pseudointima. These data suggest that alternative methods of sealing knitted Dacron conduits should be used.
一项针对86名患者的胶原蛋白密封针织涤纶导管（Tascon医疗技术公司产品）的临床试验显示，因导管狭窄进行早期再次手术的发生率很高。3年时，带瓣导管无需更换导管的精算发生率为67±14%，无瓣导管为66±20%。8根被更换的导管中有7根有一层厚且附着不牢固的假内膜。由于当前研究组患者年龄小、体型小且病情更复杂，将本系列与之前接受紧密编织的低孔隙率涤纶导管的患者系列进行比较变得复杂。然而，这些发现与该医院进行的两项实验室研究结果一致，这两项研究表明，Tascon导管中使用的胶原蛋白吸收特别缓慢，导致假内膜与导管之间的附着力较弱。这使得在假内膜深层发生出血性剥离。这些数据表明，应采用其他密封针织涤纶导管的方法。
