Thoratec Vectra Manual Del Usuario página 9

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Vectra Vascular Access Graft
10. Retract the sheaths while gently pushing the graft loop into the pocket, again
assuring the loop portion is smooth and that the more densely reinforced area is
positioned at the loop apex. (Figure 10)
11. Carefully remove the first sheath followed by the other sheath, leaving the graft in
place subcutaneously. (Figure 11)
Do not attempt to reposition the graft after sheath removal.
12. After sheath removal, do not pull the graft or attempt to reposition.
The Vectra Tunneler is a reusable device. Clean and sterilize before each use
using the procedures listed in the Vectra Tunneler Instructions for Use.
Anastomotic Preparation
Once the graft is properly positioned, an anastomosis should be made between the vessel
and the graft. The end of the graft should be beveled to accommodate a smooth lie of the
graft. The anastomosis can be performed using a one or two-suture technique. The other
end of the graft should be trimmed and anastomosed in the same manner. Note that the
graft may be cut and/or sutured at any point along its reinforced length (Figure 12). (Also
see "Precautions" statement #5.)
Suturing
Best results are achieved using a tapered, noncutting needle with a nonabsorbable
monofilament 5.0 or 6.0 suture approximately the same size as the needle. Care must
be taken to follow the curve of the needle and pull the suture at a 90° angle assuring
the needle penetrates all three layers of the graft to minimize suture hole elongation
and bleeding. Use systemic or local heparinization unless contraindicated.
Avoid excessive tension that may cause suture holes to elongate or tear; undue ten-
sion on the suture line; gaps between the graft and host vessel; and inappropriate
Figure 10. Graft loop in pocket
Figure 11. Sheath removal
Figure 12. Completed graft anastomosis
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