Replacement of Large Veins with Free Inverted Segments of Small Bowel

Experimental work indicates that inverted free segments of small bowel can be used successfully as autografts in the replacement of segments of major veins in dogs. Success has been obtained using a graft in which the mucosa, muscularis, and serosa have been removed by abrasion. The resultant tube is then comprised essentially of submucosa which provides a trellis for complete endothelialization. When the ostium of the graft is of large size, the vein can be sectionel obliquely to match the diameter of the bowel. Infection has not been a problem with any inverted graft. It is of special significance that a small bowel vein graft has been successfully used for the first time in a human patient. (Author)