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Mentions: At necropsy, gross examination showed a patent lumen in all specimens. The external surface was smooth and had area of depression at the site of graft. There was no abscess formation or sing of infection in the neck. There was evidence of adhesion of adjacent muscles to the trachea. There was evidence of neovascularization from the adjacent muscles to the aortic graft. Microscopic examination of H&E stained sections of grafted aorta and the anastomotic site revealed well healed anastomosis in all animals. There were areas of mild chronic inflammation, fibrosis, foreign body granuloma and squamous metaplasia in the animals sacrificed within two months of operation. In the animals sacrificed longer that 2.5 months, Pathology revealed no foreign body granuloma, minimal inflammation and ciliated columnar epithelium coverage of grafted aorta and neovascularization of aortic wall [Fig 2 and Fig 3], [Table 1].
Tracheal replacement by autogenous aorta
Bottom Line: Tracheal defects may occur after trauma or prolonged intubation.Resection of tracheal tumors also poses a major challenge for substitution.In an effort to solve this problem, different techniques have been tried with little success.
Affiliation: Department of Surgery, New York Hospital Queens, Weill College of Cornell University, New York, USA. email@example.com
Abstract: Tracheal defects may occur after trauma or prolonged intubation. Resection of tracheal tumors also poses a major challenge for substitution. In an effort to solve this problem, different techniques have been tried with little success. We report on a new animal model which showed acceptable results with fewer complications.We replaced 5 cm of cervical trachea in 10 dogs with harvested infra-renal aorta and repaired the aortic defect with Dacron graft.Necropsy of the grafted aorta and anastomotic site revealed well healed anastomosis in all animals together with ciliated columnar epithelium coverage of grafted aorta and neovascularization of aortic wall.Aortic graft is preferable to other substitutes because of less antigenicity, less vascularity, and no mucous secretions or peristalsis.
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