|
KMID : 0377619690160010057
|
|
Korean Jungang Medical Journal
1969 Volume.16 No. 1 p.57 ~ p.66
|
|
|
Patch Graft of the Pulmonary Artery
|
|
|
|
|
Abstract
|
|
|
Macroscopic and histological studies were done on the patch graft of the main pulmomary artery trunk to expand the arterial lumen, utilizing crimped dacron vessel piece, homologous pericardium preserved in 70% ethlyalcohol, and fresh autogenous pericardium.
Thirty dogs were grafted, among which there are one operative death and five short term survivors. The former expired due to laceration of the posterior aspect of pulmonary artery during dissection and most of the immediate post-operative deaths were due to infection, notably empyema. One, two, three, and four months post-operative long-term survivors were sacrificed to obtain specimens in each group respectively.
The following observations were made in the long-term survivors.
(A) Macroscopic findings:
In one month specimens of the each group rough and thin loosely attached membrane on the vascular luminal surface of the patch was noticed but adventitial surface showed dense adhesion to the pericardium.
Up to two months the intimal surface of the patch was rather rough in dacron and homopericardium, but in autopericardium it was smooth and glistening.
In three months specimens, autopericardium patch showed completely smooth, glistening, and firm intimal surface which could hardly be differentiated from the imtima of the host´s pulmonary artery.
In dacron and homopericardium groups the above mentioned patch capsule findings were noted in the four months groups.
In four months specimens suture materials were conpletely incorporated into the host tissue.
No aneurysmal dilatation nor thrombose were noted: .. ,
Shrinkage of the graft in the long-term survivors were most remarkable in dacron and least in preserved homograft groups.
(B) Microscopic findings:
One months groups showed acute inflammatory processes, mainly consisting of neutrophile polymorphnuclear leucocyte infection and small necrotic debris with scattered round cells.
Two months groups showed mixed findngs of receding inflamatory reactioin and reparing process, with abundant small cells, fibroblasts, and fibrocytes in and around the patch.
In three months group reparing process was dominant with many fibroblasts and fibrocytes showing connective tissue proliferation and scattered small round cells and large mononuclear cells.
In four months group fibrous connective tissue surrounded the patch completely and incorporated into it firmly. Very slight or almost no cell infiltration was noted. Intimal surface. of this capsule was smooth and showed endothelialization which can not be differentiated from the host´s intima.
In autopericardium group connective tissue capsule and endothelializaiion was complete in three months group showing the above mentioned findings.
Among these three kinds of patch groups dacron showed the most severe and autopericardium showed the least tissue reaction.
The autopericardium group required shorter period of time for complete healing than dacron and homopericardium.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|