ABSTRACT
Objetivo: El infarto de miocardio es la causa más común de fallo cardíaco congestivo. El objetivo de este trabajo es evaluar, en el animal de experimentación, los efectos morfológicos e histológicos de la implantación de plasma autógeno rico en plaquetas en el corazón de ovejas previamente infartadas. Métodos: Se utilizaron 24 ovejas lacha hembras, en las que se produjo quirúrgicamente un infarto agudo de miocardio, mediante toracotomía izquierda y ligadura permanente de 2 arterias coronarias (primera y segunda diagonal). Tras la ligadura de las arterias coronarias 3 ovejas fallecieron por fibrilación ventricular. Pasadas 3 semanas de la ligadura coronaria, las ovejas fueron reoperadas por esternotomía media vertical. En 6 de ellas (grupo control) se inyectó suero fisiológico en la zona del infarto. En 15 se inyectó gel plaquetario. Todas las ovejas fueron sacrificadas a las 9 semanas de evolución de la segunda cirugía. Resultados: En los corazones tratados con plasma rico en factores de crecimiento (PRGF) destaca la neoformación vascular en los cortes de hematoxilina-eosina y de factor VIII, a diferencia de los no tratados. Conclusiones: La inyección de factores de crecimiento plaquetarios, PRGF, en el corazón de ovejas previamente infartadas favorece la mitogénesis y la angiogénesis. El uso de PRGF autógeno es sencillo y seguro, no provocando toxicidad ni desencadenando reacciones inmunológicas ni inflamatorias.
Objective: Myocardial infarction is the most common cause of congestive heart failure. The objective of this work is to evaluate, in experimental animals, morphological and histological effects of the implantation of autologous platelet-rich plasma in infarcted heart sheep. Methods: Twenty-four ewes were used, they were surgically infarcted through left thoracotomy and two coronary arteries were ligated (first and second diagonal). After coronary artery ligation three sheep died of ventricular fibrillation. Three weeks after coronary ligation, sheep were reoperated through median sternotomy. Normal saline solution was injected in the infarcted zone in 6 of them (control group) whereas platelet gel was injected in 15 of them. All sheep were euthanized at 9 weeks of evolution of the second surgery. Results: Noteworthy is the formation of new vessels in hematoxylin-eosin-stained sections and factor VIII in plasma rich in growth-factors (PRGF)-treated hearts. Conclusions: Injection of platelet growth factors, PRGF, in previously infarcted sheep hearts promotes mitogenesis and angiogenesis. The use of autologous PRGF is simple and safe, causing no toxicity or immune-inflammatory reactions.
Subject(s)
Animals , Female , Myocardial Infarction/therapy , Platelet-Rich Plasma , Myocardial Infarction/pathology , SheepABSTRACT
OBJECTIVE: Myocardial infarction is the most common cause of congestive heart failure. The objective of this work is to evaluate, in experimental animals, morphological and histological effects of the implantation of autologous platelet-rich plasma in infarcted heart sheep. METHODS: Twenty-four ewes were used, they were surgically infarcted through left thoracotomy and two coronary arteries were ligated (first and second diagonal). After coronary artery ligation three sheep died of ventricular fibrillation. Three weeks after coronary ligation, sheep were reoperated through median sternotomy. Normal saline solution was injected in the infarcted zone in 6 of them (control group) whereas platelet gel was injected in 15 of them. All sheep were euthanized at 9 weeks of evolution of the second surgery. RESULTS: Noteworthy is the formation of new vessels in hematoxylin-eosin-stained sections and factor viii in plasma rich in growth-factors (PRGF)-treated hearts. CONCLUSIONS: Injection of platelet growth factors, PRGF, in previously infarcted sheep hearts promotes mitogenesis and angiogenesis. The use of autologous PRGF is simple and safe, causing no toxicity or immune-inflammatory reactions.
Subject(s)
Myocardial Infarction/therapy , Platelet-Rich Plasma , Animals , Female , Myocardial Infarction/pathology , SheepABSTRACT
Postcardiotomy sternal wound complications remain challenging. We looked at the effects of plasma rich in growth factors (PRGF) as an agent on sternal bone healing. In 24 female sheep, a median sternotomy was surgically created. In 12 of them (group control) the sternum was closed with three figure-of-eight wires. In 12 (group PRGF) three clots of autologous PRGF were applied over the sternum after its closure in the same manner as the control group. All sheep were killed at the nine-week follow-up. The sternum and the surrounding soft tissue was removed and fixed in formaldehyde. Transversal sections of the bone were obtained, decalcified and stained with hematoxylin and eosin. In the control group, we found extensive cartilaginous areas. In the PRGF group, the presence of trabecular bone tissue was common, with formation of hematopoietic medullary tissue. The process of new bone formation was accelerated in the PRGF group at the nine-week follow-up. In contrast, in the control group, the presence of cartilaginous tissue was the most common finding.
Subject(s)
Biological Therapy/methods , Intercellular Signaling Peptides and Proteins/blood , Osteogenesis , Platelet-Rich Plasma , Sternotomy , Sternum/surgery , Wound Healing , Animals , Chondrogenesis , Feasibility Studies , Female , Models, Animal , Sheep , Sternotomy/adverse effects , Sternum/metabolism , Sternum/pathology , Time FactorsABSTRACT
La obesidad mórbida es una enfermedad crónica, sin tratamiento efectivo en la actualidad, que representa una seria amenaza para la salud física y psíquica del paciente, por la grave repercusión que ejerce sobre los diversos sistemas corporales. Se caracteriza por un incremento de los riesgos de mortalidad y morbilidad, sobre todo cardiovasculares y respiratorios, durante el período perioperatorio. La cirugía por laparoscopia es, en estos momentos, la mejor respuesta terapéutica, pero su realización presenta una serie de dificultades para el anestesiólogo, derivadas tanto del tratamiento de un paciente anatómicamente alterado y orgánicamente afectado, como por la compensación necesaria de las especiales características de la técnica laparoscópica. En la consulta de anestesia es importante hacer una valoración de las enfermedades asociadas, especialmente las cardiovasculares y respiratorias, con una atención especial a la posible dificultad para ventilar o intubar a estos pacientes. En el quirófano un anestesiólogo experimentado utilizará los fármacos de forma individualizada, en función de diversos factores, como el peso total, el peso ideal o el grado de lipofilia del propio fármaco. La ventilación mecánica de un paciente con obesidad mórbida bajo laparoscopia abdominal obliga a un equilibrio entre el mantenimiento de la normocapnia y la evitación de presiones excesivas en la vía aérea. En el postoperatorio se ha de asegurar una buena analgesia para evitar la tendencia a la inmovilización diafragmática con la consiguiente formación de atelectasias (AU)
