Morphological changes in polyester prosthesis geometry after open aortic repair.

OBJECTIVES

Aim of this study was to assess geometrical changes of implanted Dacron grafts following open surgical ascending aortic replacement.

METHODS

Geometrical Dacron graft changes were analysed during the postoperative follow-up of 215 who received ascending aortic surgery between 02/2010 and 12/2020. Data was analysed using a linear mixed effects model over long-term follow-up.

RESULTS

One-hundred forty-five (67%) patients of our cohort were male, with a median age of 61 years 52-71.5). Most patients had a history of hypertension (79%). Proximal diameter of the implanted grafts grew at a rate of 0.251 cm (0.181-0.328 cm; p < 0.001) per year. In contrast, distal diameter stayed constant over time (0.019 cm; -0.048-0.135 cm; p = 0.366), while prosthesis length measured at the centreline decreased at a rate of -0.835 cm (-0.969 cm - -0.581 cm; p < 0.001) per year.

CONCLUSION

In contrast to the native aorta, Dacron grafts seem to decrease in length over time. At the same time, there is a significant increase in proximal diameter. The specific dimensional changes, and differences to the nominal graft dimensions, should be considered at the time of graft implantation to ensure a durable platform for secondary aortic interventions.

CLINICAL TRIAL NUMBER

Not applicable. IRB: 04/02/2021 (No. 20-1302).