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May 20, 1961

Use of Polytetrafluoroethylene in Cardiac Surgery

JAMA. 1961;176(7):637. doi:10.1001/jama.1961.03040200073029

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To the Editor:—  We are concerned by the fact that polytetrafluoroethylene (Teflon) is used by cardiac surgens to replace valve leaflets. Since polytetrafluoroethylene has been found strong and inert as aortic grafts, we made tricusp semilunar polytetrafluoroethylene valves and inserted them into dogs' hearts, 15 valves in mitral position (4 woven and 11 knitted), and one in the tricuspid area.Woven polytetrafluoroethylene is rather stiff, and the cut end frays easily. Knitted polytetrafluoroethylene is soft enough; however, immediately after insertion regurgitation through the porous cloth took place. Fortunately, the small holes were sealed with fibrin soon after the heparin was neutralized with polybrene. Initially, 7 dogs survived the operation, and were well and moving about. However, they all died 2 to 9 days later from the same cause, occlusion of the valves by thrombi. Apparently the thin layer of fibrin, found so beneficial in artificial aortas, is a liability on

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