Rationale for the Development of the Gossamer Small Arterial Prosthesis

Abstract

AS A RESULT of more than a decade of investigation in the field of replacement of defects within the cardiovascular tree, our group has been able to appreciate certain basic conclusions. The first accomplishment was the establishment of a relative scale of acceptability of all known arterial graft materials (Fig 1). It is of interest to note that the fabric prostheses in general do not enjoy ultimate healing fates significantly better than homografts in general.² With respect to small caliber arteries, the canine carotid homograft demonstrates a 50% patency rate in 90 days (Fig 2). On the other hand, equivalently small caliber arterial prostheses exhibit a 90% occlusion rate within 24 hours of implantation even when the superb microsurgical technique of Jacobson is employed (oral communication, April 1968).³ Methodical study of the factors influencing the healing of arterial prostheses allowed certain basic observations, such as the relationship between