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THE JOURNAL OF CARDIOVASCULAR SURGERY
A Journal on Cardiac, Vascular and Thoracic Surgery
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
ORIGINAL ARTICLES THORACIC PAPERS
The Journal of Cardiovascular Surgery 1999 August;40(4):591-6
Successful tracheocarinal transplantation
Nakanishi R., Hashimoto M, So T., Sugaya M., Yasumoto K.
From the Second Department of Surgery School of Medicine University of Occupational and Environmental Health Kitakyushu, Japan
Background. When extensive portions of the trachea and carina are resected, grafting is required.
Methods. Two experiments were performed in dogs to assess the feasibility of extensive tracheocarinal replacement using short-segment tracheocarinal autografts, only to avoid the immunologic complexity of allografts. To determine the effect of tension on graft survival, extensive tracheal defects (12 to 18 rings) were created in four animals. These were subsequendy reconstructed using 6-ring autografts. In the second experiment, three animals underwent excision of a maximal length of trachea determined in experiment 1 including the carina. Long-term viability of each graft was assessed using bronchoscopy and histologic examination.
Results. The limit of tracheal resection successfully reconstructed using a 6-ring autograft was 14 rings (experiment 1). The tracheal grafts in which the tension was greater than 1.2 kg did not maintain their structural integrity. All of the autografts in experiment 2 were subjected to a tension of less than 1.0 kg at the anastomoses, and showed long-term viability.
Conclusions. We conclude that extensive tracheal and carinal defects may be successfully reconstructed using short-segment tracheocarinal grafts if the anastomoses are subjected to less than 1.0 kg of tension.