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Double Layer Aortic Vascular Graft
Byung Moon1, Grayson Wheatley, III
2.
1Southlake Health, Newmarket, ON, Canada,
2Wheatley Surgical, Nashville, TN, USA.
BACKGROUND: From the inception of Dacron surgical graft, the concept of single layer end-to-end aortic graft for aortic repair has not changed even though over 100,000 open aortic repairs are performed annually.The concept of a double layer aortic graft represents an innovative approach to surgical aortic repair.The purpose of the double-layer graft design is to provide a more effective and durable solution for the treatment of aortic surgery.It is to improve surgical outcomes, extend the durability of repairs, and offer a more adaptable option for aortic repair across various patient-specific conditions, including aortic aneurysms and aortic dissections.
METHODS: This novel graft design incorporates two layers: an inner and outer layer that sandwich the native aortic wall, providing structural support while preserving the native aorta. The inner layer is designed to serve as a smooth, hemodynamically efficient conduit that isolates the blood stream from the diseased aortic wall, preventing further damage of the involved portion of aortic wall.The outer layer provides external reinforcement, supporting the adventitia and stabilizing the native aortic wall against further rupture or dissection. A key benefit is to preserve the native aortic tissue, while maintaining the physiological properties of the aorta and reduces the likelihood of complications related to surgery. The double-layer design simplifies surgical techniques, leading to a marked reduction in cardiopulmonary and circulatory arrest time.
RESULTS: The double-layer graft is not only effective but also highly reproducible, making it accessible to surgeons with varying levels of expertise. By streamlining the operative process, this approach enhances the safety profile of aortic interventions and provides a reliable option for managing challenging aortic pathologies. Benchtop experiment allowed prompt anastomosis within 5 minutes and 2 ad hoc clinical cases reduced circulatory arrest time to 17 and 22 minutes, while maintaining competent distal anastomosis.
CONCLUSIONS:The double-layer graft offers a promising advancement in the surgical treatment of complex aortic aneurysms and dissections. Its ability to preserve native tissue, improve hemostasis, and reduce operative complexity makes it a significant innovation with potential for widespread adoption.
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