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The role and the clinical value of common protocols of preclotting for a woven Dacron vascular prosthesis have been investigated. A comparative study of blood loss was carried out for Standard Woven De Bakey protheses inserted in a specially constructed extracorporeal blood circuit with canine models. The system detected transport of blood across the wall of the prostheses. These measurements were supplemented by gravimetric assessment of blood clot density and scanning electronmicroscopy examination of the internal surfaces of the prostheses. The pre-operative protocols investigated included : absence of pre-treatment, precoagulation with anticoagulant-free blood and various techniques using heparinized blood subsequent to an initial blood contact (modified method of Sauvage). The effect of using heparinized animals was also investigated. Leakages in unclotted prostheses could be reduced almost five fold by any precoagulation technique. Heparinization did not cause a significant increase in leakage and considerably improved the quality of the newly deposited blood product lining on the prostheses which consisted almost entirely of fibrin and eliminated any embolization.
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C Topping, and
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April 1992,
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