Nazer Rakan I, Alhothali Abdulaziz, Albarrati Ali
Department of Cardiac Science, King Fahad Cardiac Center, College of Medicine, King Saud University Riyadh, Kingdom of Saudi Arabia.
Department of Rehabilitation Science, College of Applied Medical Science, King Saud University Riyadh, Kingdom of Saudi Arabia.
Am J Cardiovasc Dis. 2023 Apr 15;13(2):59-67. eCollection 2023.
To objectively quantify the effect of flattening the crimps in Dacron tube grafts on the radial compliance under pulsatile pressure. We aimed to minimize the dimensional changes in woven Dacron graft tubes by applying axial stretch to the graft. We hypothesize this might reduce the risk of coronary button misalignment in aortic root replacement.
In an in vitro pulsatile model that delivered systemic circulatory pressures to Dacron tube grafts, we measured oscillatory movements in 26-30 mm Dacron vascular tube grafts before and after flattening the graft crimps. We also describe our surgical methods and clinical experiences in replacing the aortic root.
Flattening the crimps in Dacron tubes with axial stretching significantly reduced the mean maximal oscillation distance measured radially during each balloon pulse (3.2 ± 0.8 mm, 95% CI: 2.6, 3.7 mm vs. 1.5 ± 0.5 mm, 95% CI: 1.2, 1.7 mm; P < 0.001).
The radial compliance of woven Dacron tubes was significantly reduced after flattening the crimps. Applying axial stretch to the Dacron grafts prior to determining the coronary button attachment site can help maintain dimensional stability in the graft, which may reduce the risk of coronary malperfusion in aortic root replacment.
客观量化涤纶人工血管压痕变平对脉动压力下径向顺应性的影响。我们旨在通过对人工血管施加轴向拉伸，使编织涤纶人工血管管的尺寸变化最小化。我们推测这可能会降低主动脉根部置换术中冠状动脉纽扣错位的风险。
在一个向涤纶人工血管输送体循环压力的体外脉动模型中，我们测量了26 - 30毫米涤纶血管人工血管压痕变平前后的振荡运动。我们还描述了我们在主动脉根部置换术中的手术方法和临床经验。
通过轴向拉伸使涤纶血管的压痕变平，显著降低了每次球囊脉冲期间径向测量的平均最大振荡距离（3.2±0.8毫米，95%置信区间：2.6，3.7毫米对1.5±0.5毫米，95%置信区间：1.2，1.7毫米；P<0.001）。
压痕变平后，编织涤纶血管的径向顺应性显著降低。在确定冠状动脉纽扣附着部位之前，对涤纶人工血管施加轴向拉伸有助于维持人工血管的尺寸稳定性，这可能会降低主动脉根部置换术中冠状动脉灌注不良的风险。
