New uncoated vascular prosthesis reduces mediastinal tube drainage after thoracic aortic surgery.

Abstract

A new vascular graft (Triplex [Vascutek Terumo, Tokyo, Japan]) has a three-layer structure and no biologic coating material. We assessed inflammatory reaction and mediastinal tube drainage after thoracic aortic surgery using this graft. Between January 2009 and September 2009, 127 patients underwent open ascending aortic or arch repair. Triplex grafts (Vascutek Terumo) were used in 39 patients. After matching surgical procedures, 35 matched pairs (35 with Triplex, group A; 35 with coated graft, group B) were created. We compared postoperative inflammatory markers, amount, and duration of mediastinal drainage between the two groups. There was no difference in postoperative inflammatory marker levels between the two groups. The median total amounts of mediastinal drainage were 690 mL (group A) and 1,500 mL (group B) (p < 0.001). The median durations of drainage were 67 and 128 hours, respectively (p < 0.001). Multivariate linear regression analyses showed that use of the Triplex graft is an independent predictor of the small amount and short duration of mediastinal drainage. Triplex grafts reduce the amount and duration of mediastinal drainage after thoracic aortic surgery, which may promote early ambulation and fast postoperative recovery.