The Use of Low Molecular Weight Dextran in Superior Vena Caval Replacement

¹ Department of Surgery and the First Surgical Service, University of Washington School of Medicine

Superior vena caval replacement with Teflon or Dacron prostheses was performed in 60 dogs. Equal numbers of each group received low molecular weight dextran, 5 per cent solution of dextrose in water or no fluid infusion postoperatively. There was no operative death, but five dogs subsequently died with the superior vena caval syndrome. Teflon prostheses were superior to Dacron substitutes with respective overall occlusion rates of 53 per cent and 80 per cent. Obstruction of Teflon prostheses treated with low molecular weight dextran, 5 per cent dextrose in water or no infusion occurred in four, five and seven out of ten dogs, respectively. Dacron prostheses suffered occlusion in eight of ten animals in each group. Of those prostheses remaining patent, low molecular weight dextran was associated with greatest degree of patency, no fluid infusion with most severe stenosis, and 5 per cent dextrose in water with intermediate narrowing. Late stenosis or occlusion, between two weeks and three months, occurred infrequently. It is concluded that low molecular weight dextran may be a helpful adjunct in superior vena caval replacement.