>Cirugía y Cirujanos
>Year 2008, Issue 3
García-Graz NJ, Galindo-Ibarra JL, García-Soto G, Mejía-Arreguín H, Trejo-Suárez J, Ramírez-Salas MÁ
Vascular graft of aponeurosis with peritoneum in dogs
Cir Cir 2008; 76 (3)
PDF: 102.18 Kb.
[Full text - PDF]
Background: Vascular autografts are commonly used to repair damage to blood vessels; however, they can be used only with those vessels of small caliber. Although synthetic vascular grafts are good options, there may be a high likelihood of thrombus formation.
Methods: An experimental animal model was used in order to evaluate feasibility and viability of a vascular autograft. Under inhalatory anesthesia, seven mongrel dogs were operated. A 4-cm vascular autograft was created with the posterior rectus aponeurosis with subjacent peritoneum, leaving the second one as the internal sheath. A 2-cm-long portion of the abdominal aorta was removed and the vascular autograft was inserted by end-end surgical anastomosis. Animals were observed for 7 weeks, evaluating clinical data of vascular insufficiency (intensity of pulse, temperature and trophic changes of the legs). At the end of the experiment, aortography under fluoroscopic visualization was performed. Dogs were sacrificed and autograft removed in order to evaluate permeability.
Results: All dogs survived until the end of the procedure. Vascular autograft was easy to create. During surgery, no evidence of bleeding of the anastomosis or the graft suture was noted. At the end of the procedure, no clinical signs of vascular insufficiency were noted; radiographic evaluation of the autograft showed no dye leakage at any level. Autografts were removed and no signs of thrombus formation were noticed.
Conclusions: Feasibility of the vascular autograft was demonstrated with good permeability and no thrombogenicity.
||Vascular autografts, peritoneum, aponeurosis.
1. Turcotte JG, Campell DA, Dafoe DC, Behrendt DM, Kirsh MM, Marks WH. Transplante. En: David CS, ed. Principios de Cirugía. México: McGraw-Hill;1991. p. 261
2. Hughes CW. Arterial repair during the Korean war. Ann Surg 1958;147:555-561.
3. Thomas JH, Pierce GE, Iliopoulos JI, Hemreeck AS. Selección de injertos vasculares. Clin Quir Norteam 1988;4:937-947.
4. Pötzsch B, Grulich-Henn J, Rössing R, Wille D, Müller-Berghaus G. Identification of endothelial and mesothelial cell in human omental tissue and in omentum-derived cultured cells by specific cell markers. Lab Invest 1990;63:841-852.
5. Whitaker D, Papadimitriou JM, Walters MN. The mesothelium: its fibrinolytic properties. J Pathol 1992;136:291-296.
6. Van Hinsbergh VW, Kooistra T, Scheffer MA, van Bockel JH, van Muijen GN. Characterization and fibrinolytic properties of human omental tissue mesothelial cells: comparison with endothelial cells. Blood 1990;75:1490-1497.
7. Pronk A, de Groot PG, Hoynck van Papendrecht AA, Verbrugh HA, Leguit P, van Vroonhoven TJ, et al. Thrombogenicity and procoagulant activity of human mesothelial cells. Arterioscler Thromb 1992;12:1428-1436.
8. Hoenig MR, Campbell GR, Rolfe BE, Campbell JH. Tissue-engineered blood vessels. Alternative to autologous grafts? ATVB 2005;25:1128-1144.
9. Sterpetti AV, Hunter WJ, Schultz RD. Seeding with endothelial cells derived from the microvessels of the omentum and from the jugular vein: a comparative study. J Vasc Surg 1988;7:677-683.
10. Sitter T, Toet K, Fricke H, Schiffl H, Held E, Kooistra T. Modulation of procoagulant and fibrinolytic system components of mesothelial cells by inflammatory mediators. Am J Physiol 1996;271:1256-1263.
11. Richardson JV, Wright CB, Creighton BW, Hiratzka LF. The role of endothelium in the patency of small venous substitutes. J Surg Res 1980;28:556-562.
12. Vipond MN, Whawell SA, Thompson JN, Dudley HA. Peritoneal fibrinolytic activity and intra-abdominal adhesions. Lancet 1990;335:1120-1122.
13. Hernando A, García-Honduvilla N, Bellon JM, Bujan J, Navlet J. Coating for vascular prostheses: mesothelial cells express specific markers for muscle cells and have biological activity similar to that of endothelial cells. Eur J Vasc Surg 1994;8:531-536.
Sparks SR, Tripathy U, Broudy A, Bergan JJ, Kumins NH, Owens EL. Small-caliber mesothelial cell-layered polytetrafluoroethylene vascular grafts in New Zealand white rabbits. Ann Vasc Surg 2002;16:73-76.
15. Campbell JH, Efendy JL, Campbell GR. Novel vascular graft grown within recipient’s own peritoneal cavity. Circ Res 1999;85:1173-1178.
16. Cekirdekci A, Bayar MK, Yilmaz S, Cihangiroglu M, Ayan E, Duran M, et al. Reconstruction of vena cava with the peritoneum: the effect of temporary distal arteriovenous fistula on patency. Eur J Vas Endovasc Surg 2004;27:84-88.
17. Chin PT, Gallagher PJ, Stephen MS. Inferior vena cava resection with autogenous peritoneo-fascial patch graft cava repair: a new technique. Austr NZ J Surg 1999;69:391-392.
18. Akimura K, Onda M, Tajiri T, Yoshida H, Yokomoro S, Mamada Y, et al. Middle hepatic vein reconstruction using a peritoneal match: report of a case. Surg Today 2002;32:75-77.
19. Ribbe EB, Alm P, Hallberg E, Norgren LE. Evaluation of peritoneal tube grafts in the inferior vena cava of the pig. Br J Surg 1988;75:357-360.
20. Gardner E, Gray DJ, O’Rahilly R. Anatomía. 2a. ed. México: Salvat;1978.
21. Pacholewicz JK, Daloisio C, Shawarby OA, Dharan SM, Gu J, McGrath LB. Efficacy of autologous peritoneum as a biological membrane in cardiac surgery. Eur J Cardiothorac Surg 1994;8:563-565.
22. Kobori L, Dallos G, Gouw AS, Nemeth T, Nemes B, Fehervari L, et al. Experimental autologous substitute vascular graft for transplantation surgery. Acta Vet Hung 2000;48:355-360.
23. Kobori L, Doros A, Németh T, Fazakas J, Nemes B, Slooff MJ, et al. The use of autologous rectus facia sheath for replacement of inferior cava vein defect in orthotopic liver transplantation. Transpl Int 2005;18:1376-1377.
>Cirugía y Cirujanos
>Year 2008, Issue 3