ABSTRACT
Objective Allograft Vasculopathy(AV), which limits the function and long-term survival of transplanted organs, it is the most urgent problem need to be solved in the field of organ transplantation.Traditional vascular anastomosis requires excellent microsurgical techniques, it is difficult to carry out.To explore a simple and feasible AV model can provide ideas for clinical research.Methods We make vessel cannulas by using vein detained needles, pulling the thoracic aorta of donor rat in vessel cannula, both ends turned over and fixed,and then transplant it in recipient rat abdominal aorta.1, 4 and 8 weeks after transplantation, we take out of the transplanted arteries, HE stain, to observe the histomorphology and measurement the vascular intimal thickness.Results 38 of the 40 recipient rats healthy survival to the detection time points, the legs and tail can move freely, defecating and urinating normally.It is found that transplanted arteries concentric circles thickening, its histomorphology just like the AV by using HE staining.Conclutions The method of rats artery transplantation is simple and feasible, significantly shorten the time of abdominal aortic blocking, reduce surgical trauma, can improve the success rate and the reproducibility of operation.
ABSTRACT
Objective It is controversial to the surgical treatment of the DeBakey I aortic dissection.The purpose of the study was to summarize the clinical experience on total arch replacement combined with implantation of stented elephant trunk into the descending aorta for DeBakey I aortic dissection.Methods From June 2005 to March 2008,41 consecutive patients with acute(in 31)or chronic(in 10)DeBakey I aortic dissection underwent total arch replacement combined with implantation of stented elephant trunk into the descending aorta.The mean age was 57(27～76)years.Thirty-two patients were male.The procedure was performed under deep hypothermic circulatory arrest and selected cerebral perfusion.The stented elephant trunk was implanted through the aortic arch under deep hypothermic circulatory arrest.The stented elephant trunk was an 8～10 cm long self-expandable graft.Concomitant procedures included Bentall operation and total arch replacement in 24,Wheat operation and total arch replacement in 6,ascending aorta and total arch replacement in 11.Computed tomography was performed in every patient before discharge to evaluate the postoperative outcomes of the procedure.Results Cardiopulmonary bypass time was(168±32)min.The cross clamp time was(109±24)min and selective cerebral perfusion and the lowerbody circulatory arrest time wsa(31±11)min.The in-hospital mortality was 4.9%(2/41).One patient died of hemorrhagic shock and another died of multi-organ failure postoperatively.Fourteen cases suffered complications and 12 cases were cured.One case died of the cerebral hemorrhage after 4 months due to inappropriate anticoagulation during follow up.Conclusion Ascending aorta and total aortic arch replacement combined with implantation of stented trunk into descending aorta is a safe,effective and feasible way in closing the residual false lumen of the descending aorta with a low morbidity and mortality.This procedure might contribute to a better long-term outcomes of DeBakey I aortic dissection.