The Journal of Thoracic and Cardiovascular Surgery, Vol 109, Issue 5 854-857, Copyright © 1995 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
NOTE: The fulltext of this article is not available online.
Use of autologous umbilical artery and vein for vascular reconstruction in the newborn
A. A. Vlessis, H. Hovaguimian, E. Arntson and A. Starr
Department of Surgery, Oregon Health Sciences University, Portland 97201, USA.
Autologous umbilical artery and vein were evaluated as vascular conduits in
newborn lambs. Eight newborn lambs were delivered transabdominally under
sterile conditions at term. The umbilical artery and vein were dissected
from the cord and stored in culture media. On the same day, each lamb
underwent bilateral superficial femoral artery transection and
reconstruction. Nine arteries were reconstructed with autologous umbilical
vein interposition grafts, five with umbilical artery interposition grafts,
and two by primary native artery anastomosis. After the birth weight of the
lambs quadrupled (37 to 45 days), they were killed and all grafts and
anastomoses were examined grossly and histologically. At the conclusion of
the study, both native artery anastomoses (2/2) were patent. Five umbilical
vein (5/9) and two umbilical artery (2/5) autografts were also widely
patent. Patent autografts retained an intact endothelium supported by a
viable media. The nonpatent autografts had become atrophic remnants
displaying histologic signs of early closure. Graft failures are attributed
to the extreme vasoactive nature of the umbilical vessels. These
preliminary results suggest that umbilical vessels may be useful as a
vascular autograft if the vasoactive nature of these vessels can be
overcome during the immediate perioperative period.
