MANY reports are available describing the experimental replacement of the superior vena cava by various synthetic grafts.1-4 Success rates vary, but as yet no really reliable material has been found. Thrombosis of grafts, both immediate and late, has been the main source of failure; and therefore, the frequency of this complication is the standard by which a new technique or material is judged.
Autologous vein grafts have been the most successful superior caval grafts.5 Thrombus-resistant grafts of Dacron treated with graphite-benzalkonium-heparin (GBH), according to the technique of Gott, have been used with some success.6 Untreated Dacron grafts have been associated with high rates of thrombosis.7 Inverted jejunal grafts have been reported to have a 100% success rate.8
The experiments reported here constitute a comparative investigation of five different types of graft used for superior vena caval replacement. Long-term follow-up results are reported in all groups.
Fraser RE, Halseth WL, Johnson B, Paton BC. Experimental Replacement of the Superior Vena CavaAutologous Veins, Free Inverted Jejunal Grafts, and Dacron Grafts Treated With Graphite-Benzalkonium-Heparin. Arch Surg. 1968;96(3):378–385. doi:10.1001/archsurg.1968.01330210056010
Customize your JAMA Network experience by selecting one or more topics from the list below.