PMID- 22011778
OWN - NLM
STAT- MEDLINE
DCOM- 20120524
LR  - 20191210
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 41
IP  - 3
DP  - 2012 Mar
TI  - Construction of a tube-shaped tracheal substitute using fascial flap-wrapped 
      revascularized allogenic aorta.
PG  - 663-8
LID - 10.1093/ejcts/ezr012 [doi]
AB  - 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.
FAU - Wurtz, Alain
AU  - Wurtz A
AD  - Clinic of Cardiac and Thoracic Surgery, Lille University Teaching Hospital, 
      Lille, France. alain.wurtz@chru-lille.fr
FAU - Hysi, Ilir
AU  - Hysi I
FAU - Zawadzki, Christophe
AU  - Zawadzki C
FAU - Soenen, Valerie
AU  - Soenen V
FAU - Hubert, Thomas
AU  - Hubert T
FAU - Banfi, Carlo
AU  - Banfi C
FAU - Jashari, Ramadan
AU  - Jashari R
FAU - Copin, Marie-Christine
AU  - Copin MC
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20111018
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
CIN - Eur J Cardiothorac Surg. 2012 Jun;41(6):1409-10; author reply 1410. PMID: 
      22219493
MH  - Animals
MH  - Aorta, Thoracic/pathology/*transplantation
MH  - Cryopreservation/methods
MH  - Disease Models, Animal
MH  - Fascia/transplantation
MH  - Female
MH  - In Situ Hybridization, Fluorescence
MH  - Male
MH  - Neovascularization, Physiologic
MH  - Rabbits
MH  - Stents
MH  - Surgical Flaps/blood supply
MH  - Trachea/blood supply/*surgery
EDAT- 2011/10/21 06:00
MHDA- 2012/05/25 06:00
CRDT- 2011/10/21 06:00
PHST- 2011/10/21 06:00 [entrez]
PHST- 2011/10/21 06:00 [pubmed]
PHST- 2012/05/25 06:00 [medline]
AID - ezr012 [pii]
AID - 10.1093/ejcts/ezr012 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2012 Mar;41(3):663-8. doi: 10.1093/ejcts/ezr012. Epub 
      2011 Oct 18.