Fernando Villegas-Álvarez, MD, José F

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Presentation transcript:

Fibrocollagen-covered prosthesis for a noncircumferential segmental tracheal replacement Fernando Villegas-Álvarez, MD, José F. González-Zamora, MD, Angelica González-Maciel, Rosa Soriano-Rosales, Beatriz Pérez-Guille, Luis Padilla-Sánchez, MD, Rafael Reynoso-Robles, Andrea Ramos-Morales, Edgar Zenteno-Galindo, MD, Armando Pérez-Torres, MD, Eduardo E. Montalvo-Jave, MD, FACS The Journal of Thoracic and Cardiovascular Surgery Volume 139, Issue 1, Pages 32-37 (January 2010) DOI: 10.1016/j.jtcvs.2009.04.010 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Mesh and Silastic (Dow Corning, Midland, Mich) tube before subcutaneus insertion on the backs of the donor animals. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 32-37DOI: (10.1016/j.jtcvs.2009.04.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Tracheal cross-section reconstruction 4 months after implanting the prosthesis: note the deformed tracheal contour. (Toluidine blue; Original magnification 10×.) The inset shows ciliated pseudostratified columnar epithelium and capillaries in the submucosa. (Original magnification 40×.) C, Capillary cartilage. Arrows indicate glands. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 32-37DOI: (10.1016/j.jtcvs.2009.04.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Deformation of the tracheal contour evidencing the thickness of the implant wall without affecting the lumen. The posterior wall, constituted by the noncartilaginous portion of the trachea, is contracted. (Original magnification 40×.) The Journal of Thoracic and Cardiovascular Surgery 2010 139, 32-37DOI: (10.1016/j.jtcvs.2009.04.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Thickness of the tracheal wall 3 months after implantation. The labeled line indicates the thickness in micrometers from the mucosa (muc) to the adventitia (adv). A, Control group; B, experimental group. The arrow shows the fibrocollagen-covered polyester mesh. We found abundant capillaries (C). (Toluidine blue; original magnification 10×.) The Journal of Thoracic and Cardiovascular Surgery 2010 139, 32-37DOI: (10.1016/j.jtcvs.2009.04.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Micrograph of the mucosa at 1, 2, and 4 months after implantation. On the surface of the implant, we found undifferentiated cells at 1 month, serous-like and undifferentiated cells at 2 months, and the same types of cells as found in the control group at 3 and 4 months. GC, Goblet cell; CC, ciliated cells; BC, basal cells; SC, some serous-like cells. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 32-37DOI: (10.1016/j.jtcvs.2009.04.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Histology and immunohistochemistry of a fibrocollagen-covered prosthesis for segmental tracheal replacement in a rat. Collagen staining with either Masson's trichrome stain (A) or Wilder's method (B) demonstrated the presence of a layer of collagen (blue and pink fibers, respectively) already interwoven into the mesh and surrounding it. Moreover, black fibers corresponding to reticular fibers or type III collagen (B) were a prominent component of the connective tissue matrix of the mesh. Hyaluronan and glycosaminoglycans were also observed as a blue stain over the mesh (C). Immunohistochemistry for type I (D and E) and type V (F) collagen (dark brown stain) confirmed the histologic findings of collagen staining. Note the presence of numerous blood vessels near the mesh (A). (Original magnification: A, B, and F, 100×; C and E, 200×; D, 40×.) The Journal of Thoracic and Cardiovascular Surgery 2010 139, 32-37DOI: (10.1016/j.jtcvs.2009.04.010) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions