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Carinal reconstruction with a Y-shaped collagen-conjugated prosthesis

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1 Carinal reconstruction with a Y-shaped collagen-conjugated prosthesis
Takashi Sekine, MD, Tatsuo Nakamura, MD, Kazuya Matsumoto, MD, Yu Liu, MD, Hiroki Ueda, MastEng, Nobuyuki Tamura, MD, Yasuhiko Shimizu, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 119, Issue 6, Pages (June 2000) DOI: /mtc Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

2 Fig. 1 Y-shaped prosthesis made of Marlex mesh and polypropylene spirals. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

3 Fig. 2 Top, Y-shaped prosthesis after collagen conjugation. Bottom, upper view. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

4 Fig. 3 Method of carinal reconstruction: A Y-shaped silicone stent has been inserted into the prosthesis during the operation. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

5 Fig. 4 Bronchoscopic views 10 months after the operation. Neither stenosis nor granulation at the site of anastomosis with the trachea (upper left), left main bronchus (lower left), or right main bronchus (lower right) is evident. Complete covering of the mesh by regenerated tissue is observed in the region of the bifurcation (upper right). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

6 Fig. 5 Longitudinal section of the prosthesis 10 months after the operation. Longitudinal sections in all the surviving animals showed that the luminal surface was covered by smooth, whitish tissue. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

7 Fig. 6 Photomicrograph of a prosthesis removed 10 months after implantation. Ciliated epithelial cells line the prosthesis near the anastomosis (top), but squamous epithelial cells predominate in the middle portion of the prosthesis (bottom) . (Hematoxylin and eosin stain; original magnification ×100.) L, Tracheal lumen; P, polypropylene mesh. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

8 Fig. 7 Scanning electron micrographs of the luminal surface. The surface is covered by ciliated epithelial cells (top), but in the middle of the prosthesis a few ciliated epithelial cells are surrounded by cells with short microvilli (bottom). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /mtc ) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

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