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CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg 2023; 71(06): 490-496
DOI: 10.1055/s-0042-1757301
Original Thoracic

Partial Tracheal Defects Closure using Glutaraldehyde-Treated Autologous Pericardium

Shuhei Yoshida 
1   Department of Thoracic Surgery, Kanazawa University, Kanazawa, Japan
,
Isao Matsumoto
1   Department of Thoracic Surgery, Kanazawa University, Kanazawa, Japan
,
Daisuke Saito
1   Department of Thoracic Surgery, Kanazawa University, Kanazawa, Japan
,
Yusuke Tanaka
1   Department of Thoracic Surgery, Kanazawa University, Kanazawa, Japan
,
Hirofumi Takemura
2   Department of Cardiovascular Surgery, Kanazawa University, Kanazawa, Japan
,
Akishi Oi
3   Department of Molecular and Cellular Pathology, Kanazawa University, Kanazawa, Japan
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Abstract

Background The usefulness of autologous pericardium treated with glutaraldehyde (GA) for tracheal defect closure is unknown. This study preliminarily evaluated whether a GA-treated autologous pericardial graft can effectively close tracheal defects in a beagle model.

Methods Defects of 10 mm × 10 mm were created on the trachea of 10 beagles and divided into a GA-treated group (n = 5), with tracheal reconstruction using GA-treated pericardium, and control group (n = 5), using fresh pericardium. Repair sites were evaluated through bronchoscopy and histology. Blood flows on graft were measured using laser Doppler technique on postoperative days (PODs) 0, 4, 7, 14, 28, and 56. Repair sites were histologically evaluated on POD 56. In addition, GA-treated pericardia of three other beagles were histologically evaluated 12 months postoperatively, for long-term follow-up.

Results All animals survived; none developed anastomotic insufficiency. The mean suturing time and frequency of additional suture were significantly shorter and lower in the GA-treated group than in the control group (p = 0.002, 0.004). All animals in the control group exhibited graft contraction, whereas the GA-treated group healed with most graft residual and reepithelialization in the bronchoscopic and histological findings (p = 0.01, 0.004). Further, all long-term GA-treated pericardia of three beagles were confirmed as residual grafts with reepithelialization, without contraction, at 12 months postoperatively. Blood flows on graft using laser Doppler technique in the GA-treated group were detected at POD 14 or thereafter.

Conclusion GA-treated pericardium was easier to handle and provided favorable scaffolding, without graft contraction, compared with the nontreated pericardium at short- and long-term follow-up.

Keywords

trachea - pericardium - experimental


Publikationsverlauf

Eingereicht: 11. April 2022

Angenommen: 25. August 2022

Artikel online veröffentlicht:
10. Oktober 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Grillo HC. The history of tracheal surgery. Chest Surg Clin N Am 2003; 13 (02) 175-189
    CrossrefPubMedGoogle Scholar
  • 2 Meyer AJ, Krueger T, Lepori D. et al. Closure of large intrathoracic airway defects using extrathoracic muscle flaps. Ann Thorac Surg 2004; 77 (02) 397-404 , discussion 405
    CrossrefPubMedGoogle Scholar
  • 3 Idriss FS, DeLeon SY, Ilbawi MN, Gerson CR, Tucker GF, Holinger L. Tracheoplasty with pericardial patch for extensive tracheal stenosis in infants and children. J Thorac Cardiovasc Surg 1984; 88 (04) 527-536
    CrossrefPubMedGoogle Scholar
  • 4 Ng CK, Nesser J, Punzengruber C. et al. Valvuloplasty with glutaraldehyde-treated autologous pericardium in patients with complex mitral valve pathology. Ann Thorac Surg 2001; 71 (01) 78-85
    CrossrefPubMedGoogle Scholar
  • 5 Ozaki S, Kawase I, Yamashita H. et al. Reconstruction of bicuspid aortic valve with autologous pericardium–usefulness of tricuspidization. Circ J 2014; 78 (05) 1144-1151
    CrossrefPubMedGoogle Scholar
  • 6 Nishida H, Nakatsuka D, Kawano Y, Hiraiwa N, Takanashi S, Tabata M. Outcomes of totally endoscopic atrial septal defect closure using a glutaraldehyde-treated autologous pericardial patch. Circ J 2017; 81 (05) 689-693
    CrossrefPubMedGoogle Scholar
  • 7 van Noort R, Yates SP, Martin TR, Barker AT, Black MM. A study of the effects of glutaraldehyde and formaldehyde on the mechanical behaviour of bovine pericardium. Biomaterials 1982; 3 (01) 21-26
    CrossrefPubMedGoogle Scholar
  • 8 Chauvaud S, Jebara V, Chachques JC. et al. Valve extension with glutaraldehyde-preserved autologous pericardium. Results in mitral valve repair. J Thorac Cardiovasc Surg 1991; 102 (02) 171-177 , discussion 177–178
    CrossrefPubMedGoogle Scholar
  • 9 Sundset A, Hansen G, Haanaes OC, Line PD, Kvernebö K. Human bronchial perfusion evaluated with endoscopic laser Doppler flowmetry. Int J Microcirc Clin Exp 1993; 13 (03) 233-245
    PubMedGoogle Scholar
  • 10 Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013; 48 (03) 452-458
    CrossrefPubMedGoogle Scholar
  • 11 deLorimier AA, Harrison MR, Hardy K, Howell LJ, Adzick NS. Tracheobronchial obstructions in infants and children. Experience with 45 cases. Ann Surg 1990; 212 (03) 277-289
    CrossrefPubMedGoogle Scholar
  • 12 Fanous N, Husain SA, Ruzmetov M, Rodefeld MD, Turrentine MW, Brown JW. Anterior pericardial tracheoplasty for long-segment tracheal stenosis: long-term outcomes. J Thorac Cardiovasc Surg 2010; 139 (01) 18-23 , discussion 23–25
    CrossrefPubMedGoogle Scholar
  • 13 Filová E, Staňková L, Eckhardt A. et al. Modification of human pericardium by chemical crosslinking. Physiol Res 2020; 69 (01) 49-59
    CrossrefPubMedGoogle Scholar
  • 14 Chang Y, Tsai CC, Liang HC, Sung HW. In vivo evaluation of cellular and acellular bovine pericardia fixed with a naturally occurring crosslinking agent (genipin). Biomaterials 2002; 23 (12) 2447-2457
    CrossrefPubMedGoogle Scholar
  • 15 Barbetakis N, Samanidis G, Paliouras D, Tsilikas C. Tracheal laceration following double-lumen intubation during Ivor Lewis esophagogastrectomy. Interact Cardiovasc Thorac Surg 2008; 7 (05) 866-868
    CrossrefPubMedGoogle Scholar
  • 16 Carter JJ, Evans D, Shah P, Ura M. Iatrogenic tracheal rupture: bovine pericardial patch repair without flap reinforcement. Interact Cardiovasc Thorac Surg 2012; 14 (04) 502-503
    CrossrefPubMedGoogle Scholar
  • 17 Shomura Y, Okada Y, Nasu M. et al. Late results of mitral valve repair with glutaraldehyde-treated autologous pericardium. Ann Thorac Surg 2013; 95 (06) 2000-2005
    CrossrefPubMedGoogle Scholar
  • 18 Hisatomi K, Isomura T, Hirano A. et al. Long-term follow-up results after reconstruction of the mitral valve by leaflet advancement. Ann Thorac Surg 1992; 54 (02) 271-274 , discussion 274–275
    CrossrefPubMedGoogle Scholar
  • 19 Sinha P, Zurakowski D, Kumar TK, He D, Rossi C, Jonas RA. Effects of glutaraldehyde concentration, pretreatment time, and type of tissue (porcine versus bovine) on postimplantation calcification. J Thorac Cardiovasc Surg 2012; 143 (01) 224-227
    CrossrefPubMedGoogle Scholar
  • 20 Liao K, Frater RW, LaPietra A, Ciuffo G, Ilardi CF, Seifter E. Time-dependent effect of glutaraldehyde on the tendency to calcify of both autografts and xenografts. Ann Thorac Surg 1995; 60 (2, Suppl): S343-S347
    CrossrefPubMedGoogle Scholar