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Autologous tissue-fragmented extracardiac conduit with rapid, stable endothelialization due to angiogenesis

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Abstract

Objectives: Autologous angiogenic cytokines are known to activated by mincing stimulation, and well regulated in vivo. We applied this tissue fragmentation technique to a low-pressure pulmonary extracardiac conduit to obtain rapid endothelialization and stable neointima formation due to angiogenesis. Methods: Subcutaneous adipose tissue was obtained, minced, suspended, and sieved through highly porous fabric vascular prosthesis by pressurized injection. The adipose tissue fragmented graft with an autologous fresh pericardial monocusp valve was implanted between the right ventricle and the pulmonary artery in 13 dogs. The same grafts without fragments were implanted in 8 dogs as controls. No anticoagulation therapy was given. Results: Grafts were removed 6 to 1,128 days after implantation. In the developed grafts, angiogenesis occurred throughout the interstices of the graft wall from the ad ventitial side, and host cells proliferated and migrated. Endothelialization was completed throughout developed grafts at 2 weeks. The intima was still thin up to 1,128 days and free of degenerative changes. In control grafts, however, capillary infiltration was limited to perigraft tissue at 2 weeks and endothelialization was not completed by 3 months. Under the endothelial cell layer, laminal elastic fibers were formed through the developed graft wall by 4 months and still maintained at 1,128 days. Conclusions: The results demonstrated that adipose tissue fragmented extracardiac conduits induce rapid endothelialization and maintained thin intima with laminal elastic fibers. Long-term durability is expected based on results from using this technique in a low-pressure pulmonary system in dogs.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery The Heart Institute of Japan, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, 162-8666, Tokyo, Japan

    Makoto Ando, Yasuko Tomizawa, Yasuharu Noishiki, Masatsugu Terada & Yasuharu Imai

  2. Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women’s Medical University, Tokyo, Japan

    Yasuko Tomizawa

  3. First Department of Surgery, Yokohama City University School of Medicine, Kanagawa, Japan

    Yasuharu Noishiki

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  1. Makoto Ando
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  2. Yasuko Tomizawa
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  3. Yasuharu Noishiki
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  4. Masatsugu Terada
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  5. Yasuharu Imai
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Ando, M., Tomizawa, Y., Noishiki, Y. et al. Autologous tissue-fragmented extracardiac conduit with rapid, stable endothelialization due to angiogenesis. Jpn J Thorac Caridovasc Surg 48, 153–160 (2000). https://doi.org/10.1007/BF03218113

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  • DOI: https://doi.org/10.1007/BF03218113

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