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J Thorac Cardiovasc Surg 1994;108:337-345
© 1994 Mosby, Inc.

GENERAL THORACIC SURGERY

Experimental study on a new tracheal prosthesis made from collagen-conjugated mesh

Kyoto, Japan

Supported by grant-in-aid No. 01480342 for Developmental Scientific Research from the Ministry of Education, Science and Culture, Japan.

Received for publication Sept. 14, 1993. Accepted for publication Jan. 9, 1994. Address for reprints: Norihito Okumura, MD, Research Center for Biomedical Engineering, Kyoto University, Kawahara-cho 53, Shogoin, Sakyo-ku, Kyoto, 606, Japan.

Abstract

A new tracheal prosthesis was made from fine Marlex mesh reinforced with a continuous polypropylene spiral. The mesh and spiral were covalently grafted and further coated with pig collagen with the aim of promoting connective tissue infiltration and providing initial airtightness. Complete surgical resection and replacement of a segment (2 cm in length, three to five tracheal rings) of the cervical trachea was performed in 13 adult mongrel dogs. Two dogs died of pneumonia about 2 months after operation, and eleven dogs were killed between 3 and 26 months. The prostheses in all dogs were promptly infiltrated by the surrounding connective tissue and completely incorporated by the host trachea. Formation of respiratory epithelium, which lined the prosthetic lumen, was seen to various degrees, and, in five dogs killed at 6 months or more after reconstruction, confluent epithelization was confirmed histologically from the upper to the lower anastomotic site of the prosthesis. Marked stenosis of the prosthetic lumen caused by excessive scar tissue growth was seen in three dogs, and ulceration on the luminal surface was seen in two dogs. These results indicate that this tracheal prosthesis is highly biocompatible and promising for the repair of tracheal defects after further investigation. (J THORACCARDIOVASCSURG1994;108:337-45)

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