Document Detail


Tracheal replacement with a bioabsorbable scaffold in sheep.
MedLine Citation:
PMID:  21095312     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A significant native tracheal approximation phenomenon was observed in our previous study [Tsukada H, Ernst A, Gangadharan S, et al. Tracheal replacement with a silicone-stented fresh aortic allograft in sheep. Ann Thorac Surg 2010;89:253-8], in which sheep trachea was replaced with an allogenic aortic graft in order to attempt transplantation. Because an appropriate tracheal replacement graft has yet to be determined, other means to repair or replace tracheal tissue have to be evaluated. The aim of this study was to test a bioabsorbable scaffold for temporary tracheal grafting.
METHODS: Eight male sheep underwent cervical tracheal replacement (5 cm) using a copolymer of L-lactide and ε-caprolactone sponge tube reinforced by polyglycolic acid. A silicone stent (7 cm) was placed perioperatively to prevent graft collapse. Routine bronchoscopy and computed tomographic scans were scheduled for up to 9 months and necropsies with histologic examinations were scheduled at 9 months (n = 3), 6 months (n = 2), 4 months (n = 1), 3 months (n = 1), and 2 months (n = 1) after surgery.
RESULTS: No procedural deaths and postoperative complications occurred. Planned follow-up points were reached in all animals. Computed tomographic imaging of the grafted area showed tracheal approximation up to 75% at 9 months after surgery. Silicone stents were removed at 9 months in three animals. Symptomatic airway collapse was observed at 6 hours, 1 week, and 2 weeks after stent removal. Epithelialization of the entire grafted area was confirmed in all sheep that were followed beyond 4 months.
CONCLUSIONS: Tracheal axial approximation occurs consistently after tracheal resection and replacement. Our data suggest that bioabsorbable materials can be used as a reliable, temporary, tracheal replacement conduit.
Authors:
Hisashi Tsukada; Sidhu Gangadharan; Robert Garland; Felix Herth; Malcolm DeCamp; Armin Ernst
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1793-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Chest Disease Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
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MeSH Terms
Descriptor/Qualifier:
Absorbable Implants*
Animals
Aorta, Thoracic / transplantation*
Bronchoscopy
Disease Models, Animal
Follow-Up Studies
Graft Survival
Male
Prosthesis Design
Sheep
Stents*
Suture Techniques
Trachea / surgery*
Tracheal Diseases / surgery*
Transplantation, Homologous
Treatment Outcome
Comments/Corrections
Comment In:
Ann Thorac Surg. 2010 Dec;90(6):1797-8   [PMID:  21095313 ]

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


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