Document Detail


Construction of a tube-shaped tracheal substitute using fascial flap-wrapped revascularized allogenic aorta.
MedLine Citation:
PMID:  22011778     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Animal studies have demonstrated the feasibility of tracheal replacement by silicone-stented allogenic aortas (AAs), showing mature cartilage regeneration into the grafts. In clinical trials, this graft did not prove stiff enough to allow long-term stent withdrawal. This graft insufficiency could be due to ischaemic phase prior to neoangiogenesis. To solve this issue, we investigated both the efficacy of the rabbit lateral thoracic fascial flap as a vehicle for revascularization of the AA and construction of a tube-shaped graft with transferable vascular pedicle, for more efficient replacement of the trachea.
METHODS: Thirty-four New Zealand rabbits were used. After harvesting of donors 'thoracic aortas', the fresh aortic allografts were transplanted within 1 h, and the others were cryopreserved. Fifteen male and four female rabbits were used as recipients for fresh (n = 9) or cryopreserved (n = 10) aortic allografts that were implanted under the skin of the chest wall, after graft wrap using a pedicled lateral thoracic fascial flap. Animal sacrifice was scheduled at regular intervals up to 61 days. Macroscopic and microscopic examinations and fluorescence in situ hybridization (FISH) were used to study the morphology, revascularization process and viability of the construct.
RESULTS: There was no operative death. Animals showed no graft rejection, despite the absence of immunosuppressive therapy. They all had a satisfactory tubular morphology of their construct. Of the 19 rabbits, 15 were found to have a generally preserved histological structure of the aorta and satisfactory neoangiogenesis. In the last four, a severe wound complication was associated with necrosis of the aortic graft. FISH on three aortic grafts with satisfactory neoangiogenesis showed migration of recipient cells into the aortic graft, decreasing from the adventitial to the luminal side, associated with the persistence of cells from the donor.
CONCLUSIONS: Our results showed that the chimeric construct transformed into a well-vascularized tube-shaped organ with transferable pedicle and some degree of stiffness. Persistence of donor's cells of normal morphology into the aortic graft was suggestive of minimal ischaemia during the initial phase of revascularization. This construct might be investigated in the setting of tracheal replacement in the rabbit model.
Authors:
Alain Wurtz; Ilir Hysi; Christophe Zawadzki; Valérie Soenen; Thomas Hubert; Carlo Banfi; Ramadan Jashari; Marie-Christine Copin
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-10-18
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  41     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-20     Completed Date:  2012-05-24     Revised Date:  2012-06-29    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  663-8     Citation Subset:  IM    
Affiliation:
Clinic of Cardiac and Thoracic Surgery, Lille University Teaching Hospital, Lille, France. alain.wurtz@chru-lille.fr
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MeSH Terms
Descriptor/Qualifier:
Animals
Aorta, Thoracic / pathology,  transplantation*
Cryopreservation / methods
Disease Models, Animal
Fascia / transplantation
Female
In Situ Hybridization, Fluorescence
Male
Neovascularization, Physiologic
Rabbits
Stents
Surgical Flaps / blood supply
Trachea / blood supply,  surgery*
Comments/Corrections
Comment In:
Eur J Cardiothorac Surg. 2012 Jun;41(6):1409-10; author reply 1410   [PMID:  22219493 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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