An Arterial Prosthesis of Heterologous Vascular Origin

The PREPARATION of an acceptable biological arterial graft is based on an understanding of the physical properties of the various tissue components of the arterial wall,1and on an analysis of the reasons for failure of arterial heterografts and homografts as vascular substitutes.2 Arterial heterografts either are nonviable at the time of insertion or die shortly thereafter, and their ability to withstand pulsatile arterial pressures without disruption depends on the duration of their structural integrity and the extent to which they are invaded or enveloped by supporting host collagenous tissue. Such invasion is rendered difficult and often delayed by an inflammatory reaction to necrotic cellular and smooth muscle elements and by the prior need of the host to debride the graft of such reactive dead tissue. If the rate of infiltration or encasement by host connective tissue is rapid and early, the supported mummified heterograft may avoid rupture,