Small intestine without mucosa as a growing vascular conduit: a porcine experimental study.
OBJECTIVE
This study was conducted to check the feasibility of using small intestine without mucosa as a growing vascular conduit.


METHODS
Autologous proximal jejunum without mucosa after treatment with heparin bonding was used as a free inferior vena cava interpositional graft between the renal veins and bifurcation of inferior vena cava in 8 piglets. Intravenous ultrasonography was performed at 1 to 3 months after the operation and at autopsy.


RESULTS
One intraoperative death was related to anesthesia. At a mean follow-up of 80 days for the 7 surviving pigs, the weight had increased by 201%, from a mean of 32 kg to a mean of 94 kg. The grafts had increased in length by 128%, from a mean of 2.3 cm at implantation to a mean of 5.1 cm (P <.018) at explantation. In 6 animals the diameter of the graft was equal to that of the adjacent inferior vena cava. At postmortem examination, 6 grafts were patent. The single blocked graft had been patent 1 month after surgery. One graft had extensive septae inside, 2 had minor septae, 2 had microscopic septae, and 2 had no septae at all. Normal appearing adventitia, fibrous tissue, and endothelium (factor VIII-related antigen positive) lined all the grafts. In all 7 grafts, scattered proliferating fibroblasts (MIB1 positive) were observed.


CONCLUSIONS
Small intestine without mucosa remodels and acts like a live, growing, layered, endothelialized, nonthrombogenic (after re-endothelialization) vascular conduit in a growing pig. This graft material could have potential as a growing vascular conduit in children.
Tucker
Om P
OP
Departments of Cardiovascular Surgery, Statistics, and Pathology, University Hospital Vaudois, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. omptucker@hotmail.com
Syburra
Thomas
T
Augstburger
Monique
M
van Melle
Guy
G
Gebhard
Sandra
S
Bosman
Fred
F
von Segesser
Ludwig K
LK
D000818:Animals; D001807:Blood Vessel Prosthesis; D005500:Follow-Up Studies; D007413:Intestinal Mucosa; D007583:Jejunum / Q000254:growth & development / Q000637:transplantation* / Q000648:ultrastructure; D013552:Swine; D013997:Time Factors; D014682:Vena Cava, Inferior / Q000601:surgery