Modification of the descending thoracic aortic anastomotic site using biodegradable felt: study in a canine model with or without basic fibroblast growth factor.
Modification of the descending thoracic aortic anastomotic site using biodegradable felt: study in a canine model with or without basic fibroblast growth factor.
复制标题
使用可生物降解毛毡修改胸降主动脉吻合部位：在有或没有碱性成纤维细胞生长因子的犬模型中进行研究。
DOI：
10.1016/j.jvs.2009.08.078
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发表时间：
2010
影响因子：
4.3
通讯作者：
K. Tabayashi
中科院分区：
文献类型：
--
作者：
H. Fujiwara;Y. Saiki;Mitsuru Sato;N. Sakamoto;T. Ohashi;Masaaki Sato;Y. Tabata;K. Tabayashi
目的我们研究了在犬胸降主动脉置换模型中使用（1）不可生物降解的聚四氟乙烯（PTFE）毡、（2）可生物降解的聚乙醇酸（PGA）毡和（3）带有碱性成纤维细胞生长因子（bFGF）的PGA毡加固吻合部位的结果。具有上述增强材料之一或不具有控制增强材料。术后1个月和3个月进行组织学评估。使用张力测试仪沿主动脉段的纵轴评估吻合的生物力学强度。还在圆周方向上评估了吻合部位的局部顺应性。结果 PTFE 组的中膜明显薄于对照组（正常厚度的 65.8% ± 5.1% vs 95.0% ± 9.3%；P < .05）。与对照组相比，PTFE 组的外膜层明显更薄（对照组的 42.3% ± 8.2%；P < .05），但 PGA 和 PGA + bFGF 组的外膜层明显更厚（分别为对照组的 117.2% ± 11.3% 和 134.1% ± 14.2%；P < .05）。 PGA + bFGF 组的外膜层血管数量多于对照组、PTFE 组和 PGA 组（分别为 29.2 ± 2.1/mm2 vs 13.8 ± 0.8、5.4 ± 0.7、17.0 ± 1.3/mm2；P < .01）。四组之间吻合口处的破坏力没有显着差异。 PGA 组吻合部位的局部顺应性高于 PTFE 组（11.6 ± 1.6 10−6m2/N vs 5.6 ± 1.9 10−6m2/N；P < .05）。 结论 用 PTFE 毡加固实验主动脉壁导致中膜和外膜变薄，吻合部位血管减少。当使用可生物降解毛毡时，没有观察到这些组织学变化。除了增加外膜血管数量外，bFGF 未能增强主动脉壁的改变。所有四组中沿纵轴的吻合生物力学强度相当；然而，可生物降解的 PGA 毡组的局部血管顺应性更好。
OBJECTIVESWe investigated the outcomes of reinforcing anastomotic sites using (1) nonbiodegradable polytetrafluoroethylene (PTFE) felt, (2) biodegradable polyglycolic acid (PGA) felt, and (3) PGA felt with basic fibroblast growth factor (bFGF) in a canine descending thoracic aortic replacement model.METHODSThirty-seven beagles underwent descending thoracic aorta replacement using a prosthetic graft with one of the above-mentioned reinforcements or no reinforcement for controls. Histologic evaluations were carried out 1 month and 3 months after surgery. The biomechanical strength of the anastomosis was assessed along the longitudinal axis of the aortic segments using a tensile tester. Local compliance at the anastomotic site was also evaluated in the circumferential direction.RESULTSThe media was significantly thinner in the PTFE group than in the control group (65.8% ± 5.1% vs 95.0% ± 9.3% of normal thickness; P < .05). Relative to the control group, the adventitial layer was significantly thinner in the PTFE group (42.3% ± 8.2% of control; P < .05) but significantly thicker in the PGA and the PGA + bFGF groups (117.2% ± 11.3% and 134.1% ± 14.2% of control, respectively; P < .05). There were more vessels in the adventitial layer in the PGA + bFGF group than in the control, PTFE, and PGA groups (29.2 ± 2.1/mm2vs 13.8 ± 0.8, 5.4 ± 0.7, 17.0 ± 1.3/mm2, respectively; P < .01). There were no significant differences between the four groups in the failure force at anastomotic sites. Local compliance at the anastomotic site was higher in the PGA group than that in the PTFE group (11.6 ± 1.6 10−6m2/N vs 5.6 ± 1.9 10−6m2/N; P < .05).CONCLUSIONReinforcement of the experimental aortic wall with PTFE felt resulted in thinning of the media and adventitia and fewer vessels at the anastomotic site. These histologic changes were not observed when biodegradable felt was used. The bFGF failed to augment the modification of the aortic wall with the exception of increased adventitial vessel number. Biomechanical strength of the anastomosis along the longitudinal axis was comparable in all four groups; however, local vascular compliance was better in the biodegradable PGA felt group.