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The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 434-441, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
SC Balderman and G Weinblatt
A series of experiments were conducted to assess the possibility of
revascularizing tracheal homografts with an omental pedicle flap. Three
different experiments were performed. In Group I (N = 4) a ten-ring
tracheal allograft was embedded into the greater omentum of a recipient
animal for 30 days. At reexploration these four allografts were found to
have been transformed into a tube consisting mainly of connective tissue.
To provide more collateral circulation, we immediately reanastomosed an
eight-ring tracheal autograft in Group II animals (N = 7). Collateral blood
supply was possibly available from the surrounding mediastinal tissues, the
recipient trachea, and the transposed omental graft. Tracheal malacia and
loss of rings 4,5, and 6 was a consistent finding and cause of death. A
third group of animals (Group III) underwent a similar operation with the
addition of free bone grafts being applied to the external surface of the
autograft to impede significant tracheal stenosis. The long-term results
and the findings when the animals were put to death were the same as in
Group II. We conclude that the omental pedicle graft cannot sustain
chondrocyte viability. Thus a reliable method for revascularization of a
tracheal transplant remains to be found.
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