Modifying Anastomotic Site in Thoracic Aortic Surgery by Using Biodegradable Felt Strips With or Without Basic Fibroblast Growth Factor

Objectives: The purposes of this investigation are to elucidate sequelae of reinforcing the anastomotic site with nonbiodegradable PTFE felt, biodegradable polyglycol acid (PGA), and PGA with basic fibroblast growth factor (bFGF) in a thoracic aortic replacement model.

Methods: Replacement of the descending thoracic aorta was performed in beagles (n = 19) using the above three different materials or without reinforcement (control).

Results: The medial thickness in the PTFE group was significantly lower than that of the PGA with bFGF group (66±5% versus 90±4% of control, < 0.05). The adventitial layer in the PTFE group significantly decreased in thickness compared to control (42±8% of control, < 0.05), whereas those in the PGA and PGA with bFGF groups significantly thickened (117±11 and 134±14% of control, respectively, < 0.05), which was associated with increased vessel number. The failure force measured at anastomotic sites did not show statistical difference between the four groups.

Conclusions: The aortic wall at the anastomotic site reinforced with nonbiode-gradable felt showed thinning of both media and adventitia. These changes were associated with diminished vessels in the adventitial layer. Biodegradable felt with or without bFGF reversed these histological changes without altering biomecha-nical strength.