The Growth of Crimped Dacron Aortic Bypass Graft: A Case Report.

The author presents the case of a patient who was operated upon for extensive stricture of the abdominal aorta at the age of 8 years and of a height of 4'2". In the course of surgery a 12-mm diameter woven crimped vascular prosthesis was anastomosed end-to-side to the lower thoracic as well as to the infrarenal abdominal aorta to bypass the strictured aortic segment. During the following years the patient underwent four consecutive aortograms and also several surgical interventions on the visceral arteries but not on the bypass graft. The latest arteriogram taken at the age of 31 and height of 6'6" showed an approximately 15% enlongation responding with the appropriate growth of the adjacent vertebra during the years undoubtedly due to stretching, induced straightening of the "crimps," and some blunting of the angle by which the graft was attached to the thoracic aorta, an additional factor which made the course of the prosthesis adapt to body growth. The case illustrates that if crimped Dacron grafts are implanted in a growing individual in an appropriate manner, one may count that he or she will probably adapt to the natural increase of body length.