Compliance in anastomoses with and without vein cuff interposition

Abstract

Objective: To compare anastomotic compliance in end-to-side anastomoses with and without vein cuff interposition. Materials: Polytetrafluoroethylene graft to bovine carotid artery without (standard) and with vein interposition (Linton-patch and Miller-cuff). Methods: Zonewise compliance measurement of end-to-side anastomoses in an in-vitro circulation system. The zone most distal to the suture-line served as reference compliance. Results: Directly distal to the suture-line the compliance of the Linton-patch (5.6±1.6%/100 mmHg) and Miller-cuff anastomosis (5.2±1.1%/100 mmHg) more closely approached reference compliance (standard: 5.0±1.2, Linton-patch: 4.5±1.5, Miller-cuff: 4.9±1.0%/100 mmHg) than that of the standard anastomosis (7.9±3.0%/100 mmHg). The maximal compliance values of the Linton-patch (9.5±2.3%/100 mmHg) and Miller-cuff anastomoses (9.8±2.7%/100 mmHg) were significantly higher than that of the standard end-to-side anastomosis (7.9±3.0%/100 mmHg). However, maximal compliance was shifted from the zone directly distal to the suture line in the standard end-to-side anastomosis, to the vein cuff interposition in the Linton-patch and Miller-cuff anastomoses. Conclusion: The shift in maximal compliance to the wider portion of the anastomosis in the Miller-cuff and Linton-patch anastomoses may obviate reocclusion.