Disproportionate enlargement of the pulmonary autograft in the aortic position in the growing pig Paul H. Schoof, MDa, Mark G. Hazekamp, MD, PhDa, Gijs.

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Presentation transcript:

Disproportionate enlargement of the pulmonary autograft in the aortic position in the growing pig Paul H. Schoof, MDa, Mark G. Hazekamp, MD, PhDa, Gijs van Wermeskerken, MDa, Emile de Heer, PhDb, Jan A. Bruijn, MD, PhDb, Adriana Gittenberger-de Groot, MD, PhDc, Hans A. Huysmans, MD, PhDa The Journal of Thoracic and Cardiovascular Surgery Volume 115, Issue 6, Pages 1264-1272 (June 1998) DOI: 10.1016/S0022-5223(98)70208-9 Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 1 Sketch showing pulmonary autograft replacement of the aortic root and orthotopic implantation of a pulmonary homograft as performed in group 1 piglets (top) and ascending aortic replacement with a valveless pulmonary autograft as performed in group 2 piglets (bottom). The Journal of Thoracic and Cardiovascular Surgery 1998 115, 1264-1272DOI: (10.1016/S0022-5223(98)70208-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 2 Autopsy specimens of homograft (bottom) and autograft (top) of a 160 kg pig showing size difference after growth. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 1264-1272DOI: (10.1016/S0022-5223(98)70208-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 3 Detail of autograft specimen shown in Fig. 5, showing “growth tracks” left by the sutures. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 1264-1272DOI: (10.1016/S0022-5223(98)70208-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 4 Graphs showing the relationship between total cuspal weight, cuspal height, and total cuspal width of the pulmonary autograft and the body weight in group 1 animals. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 1264-1272DOI: (10.1016/S0022-5223(98)70208-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 5 Operative and autopsy samples of native pulmonary artery, aorta, and pulmonary autograft in one of the group 2 animals showing difference in size before and after growth. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 1264-1272DOI: (10.1016/S0022-5223(98)70208-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 6 Graphs showing the increase in circumference (top) and thickness (middle) of the pulmonary autograft (filled squares), native pulmonary artery (filled circles), and native aorta (filled triangles) and the volumetric increase (bottom) of the transplanted pulmonary autograft segment in each and all group 2 animals. Because group 2 animals were studied systematically at 10 months alone, the linear regression lines shown are intended for visual reference and do not imply that the increases across time necessarily follow a linear pattern. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 1264-1272DOI: (10.1016/S0022-5223(98)70208-9) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 7 Elastin van Gieson–stained microscopic section (10× magnification) of the transition zone between the aorta (top) and pulmonary autograft (bottom). The aortic media shows densely packed, well-organized elastic fibrils, whereas the pulmonary autograft media still shows the thinner, loosely arranged media, characteristically seen in the pulmonary artery wall. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 1264-1272DOI: (10.1016/S0022-5223(98)70208-9) Copyright © 1998 Mosby, Inc. Terms and Conditions