Advertisement

Pedicled pericardial flap for pulmonary artery in adult dogs

  • Kaori Sato
  • Atsushi Iguchi
  • Yoshiaki Tanaka
  • Masaki Hata
  • Mitsuaki Sadahiro
  • Hitoshi Yokoyama
  • Mikio Ohmi
  • Koichi Tabayashi
Original Article

Abstract

Objective: Stenosis of extracardiac conduit after reconstruction of right ventricle outflow tract is a serious problem, and the purpose of this study was to identify the suitability of broadly pedicled autologous pericardial flap for the reconstruction of pulmonary artery trunk in adult dogs.Methods: Eight mongrel dogs had replacement of a pulmonary artery trunk with extracardiac conduit, in which prosthetic vascular graft formed the posterior wall and pedicled (group P, n = 5) or free (group F, n = 3) autologous pericardium created the anterior wall. Six months after the operation, pressure gradient across the conduit were measured and put to death for pathological examinations.Results: Pressure gradient across the conduit in goups F and P was 16.0 ± 16.8 mmHg and 1.4 ± 1.7 mmHg respectively. In the microscopic examination, flaps of group P had neo-intimal cells in the innermost loyer, abundant cellular component with elastic fiber was seen within the middle layer, and collagen tissue within the outer layer. Conversely, the presence of calcification was shown within collagen fiber layer of all patches in group F. Sparse cellular component and the absence of neo-intimal cells were also observed in group F.Conclusions: Broadly pedicled pericardial flap is more conceivable to prevent the development of conduit stenosis after right ventricle outflow tract reconstruction, if compared with free pericardial patches.

Key words

right ventricular outflow tract pedicled pericardium dog 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Tonkin ILD, Allen RF, Casini M, Marin-Garcia J, Anthony CL, Bell ED, et al. Modified Shumacker repair of transposition of the great arteries — surgical and angiocardiographic considerations. J Thorac Cardiovasc Surg 1983; 85: 306–12.PubMedGoogle Scholar
  2. 2.
    Nkere UN, Whawell SA, Sarraf CE, Scofield JB, Thompson, JN, Taylor KM. Perioperative histologic and ultrastructual changes in the pericardium and adhesions. Ann Thorac Surg 1994; 58: 437–44.PubMedCrossRefGoogle Scholar
  3. 3.
    Steffee CH, Iskandar SS. Intravascular papillary endothelial hyperplasia in a thrombosed renal allograft vein. Hum Pathol 1996; 27: 986–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Lepley Jr D, Hausmann PF, Weisel W. The fate of pericardial pedicled graft used in a fixed position in various chambers of the dog heart. J Thorac Cardiovasc Surg 1959; 37: 711–9.Google Scholar
  5. 5.
    Cerfolio RJ, Danielson GK, Warnes CA, Puga FJ, Schaff HV, Anderson BJ, et al. Results of an autologous tissue reconstruction for replacement of obstructed extracardiac conduits. J Thorac Cardiovasc Surg 1995; 110: 1359–68.PubMedCrossRefGoogle Scholar
  6. 6.
    Ohmi M, Tabayashi K, Sato K, Nagamine S, Shoji Y. Extracardiac conduit composed of gutter-shaped prosthesis and pedicled pericardial valved patch for pulmonary trunk reconstruction. Ann Thorac Surg 1996; 62: 1183–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Haneda K, Thomas R, Breazeal DG, Sands MP, Dillard DH. The importance of inspired carbon dioxide on induced hypothermia under halothan-ether azeotrope anesthesia. J Cardiovasc Surg 1984; 25: 67–74.Google Scholar
  8. 8.
    Iguchi A, Haneda K, Sato S, Horiuchi T. Determination of safe interval of circulatory arrest from the crebral metabolic aspect. Tohoku J Exp Med 1986; 149: 191–204.PubMedCrossRefGoogle Scholar
  9. 9.
    Hjelms E, Pohlner P, Barratt-Boyes BG, Gavin JB. Study of autologous pericardial patch-grafts in the right ventricular outflow tracts in growing and adult dogs. J Thorac Cardiovasc Surg 1981; 81: 120–3.PubMedGoogle Scholar
  10. 10.
    Clarke CP, Barratt-Boyes BG, Sims FH. The fate of preserved homograft pericardium and autogenous pericardium within the heart. Thorax 1968; 23: 111–20.PubMedCrossRefGoogle Scholar
  11. 11.
    Hvass U. Pedicled pericardial flaps. J Thorac Cardiovasc Surg. 1997; 114: 958.Google Scholar
  12. 12.
    Khoury W, Lang-Lazdunski L, Vernant F, Thibert M, Leca F. Pedicled pericardium for repair of right ventricular outflow tract and pulmonary atrial stenosis in tetralogy of Fallot: a six-year experience. J Thorac Cardiovasc Surg 1996; 112: 424–32.PubMedCrossRefGoogle Scholar
  13. 13.
    Hvass U, Khoury W, Pansard Y, Videcoq M. Repair of pulmonary artery branches with broadly based autologous pericardial flaps. J Thorac Cardiovasc Surg 1988; 95: 738–40.PubMedGoogle Scholar
  14. 14.
    Spodick DH. Macrophysiology, microphysiology, and anatomy of the pericardium: a synopsis. Am Heart J 1992; 124: 1046–51.PubMedCrossRefGoogle Scholar
  15. 15.
    Nkere UN, Whawell SA, Sarraf CE, Scofield JB, Thompson, JN, Taylor KM. Perioperative histologic and ultrastructual changes in the pericardium and adhesions. Ann Thorac Surg 1994; 58: 437–44.PubMedCrossRefGoogle Scholar
  16. 16.
    Kaufman BR, Fox PL, Graham LM. Platelet-derived growth factor production by canine aortic grafts seeded with endothelial cells. J Vasc Surg 1992; 15: 699–706.PubMedCrossRefGoogle Scholar
  17. 17.
    Margolin DA, Kaufman BR, DeLuca DJ, Fox PL, Graham LM. Increased platelet-derived growth factor production and intimai thickening during healing of Dacron grafts in a canine model. J Vasc Surg 1993; 17: 858–66.PubMedCrossRefGoogle Scholar
  18. 18.
    Shinoka T, Shum-Tim D, Ma PX, Isogami N, Langer R, et al. Creation of viable pulmonary artery autograft through tissue engineering. J Thorac Cardiovasc Surg 1998; 115: 536–46.PubMedCrossRefGoogle Scholar
  19. 19.
    Massia SP, Hubbell JA. Tissue engineering in the cascular graft. Cytotechnology 1992; 10: 189–204.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 2000

Authors and Affiliations

  • Kaori Sato
    • 1
  • Atsushi Iguchi
    • 1
  • Yoshiaki Tanaka
    • 1
  • Masaki Hata
    • 1
  • Mitsuaki Sadahiro
    • 1
  • Hitoshi Yokoyama
    • 1
  • Mikio Ohmi
    • 1
  • Koichi Tabayashi
    • 1
  1. 1.Department of Thoracic and Cardiovascular SurgeryTohoku University School of MedicineSendaiJapan

Personalised recommendations