• Title/Summary/Keyword: Grafts

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Comparison of Patency and Viability in Fresh and Cryopreserved Arterial and Venous Allograft Conduits in Dogs (개에서 동맥과 정맥 동종 이식편의 냉장, 보존 방법에 따른 개존율 및 생육성에 관한 연구)

  • Song, Hyun;Kang, Shin-Kwang;Ryu, Yang-Gi;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.149-159
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    • 2008
  • Background: With increasing coronary bypass and peripheral vascular surgeries, the demand for homologous vascular or synthetic conduits has continued to grow, but wide-spread application has been limited by dismal patency rates. Although cryopreserved allograft valves may provide a suitable alternative, current viability or patency of implanted allograft vascular conduits has been unsatisfactory. Material and Method: We serially analyzed the outcomes of canine femoral artery and saphenous vein allograft implants after storage in either $4^{\circ}C\;or\;-170^{\circ}C$. Result: There were no differences in graft flow rate (patency) (p=0.264), rate of thrombosis (p=0.264), presence of endothelium (p=0.587), or immunohistochemical staining for thrombomodulin (p=0.657) were detected between grafts stored in $4^{\circ}C\;and\;-170^{\circ}C$. Greater flow occurred in the arterial grafts versus the venous grafts (p=0.030), irrespective of the preservation method, with a significantly lower incidence of thrombosis (p=0.030) in arterial allografts. There was a correlation coefficient of -0.654 between thrombosis and positive immunohistochemical staining for thrombomodulin (p=0.006) and a correlation coefficient of 0.520 (p=0.0049) between the endothelial presence and positive immunohistochemical staining for thrombomodulin. The relationship between the presence of endothelium and thrombomodulin expression failed to show any correlation within the first 2 weeks (p=0.306). However, a strong correlation was seen after 1 month (p=0.0008). Conclusion: Tissue storage in either $4^{\circ}C\;or\;-170^{\circ}C$ in 10% DMSO/RPMI-1640 preservation solution preserved grafts equally well. In terms of thrombosis and graft patency, arterial grafts were superior to venous grafts. Considering the poor correlation between thrombomodulin expression and the presence of an endothelium in the implanted graft within the first two weeks, grafts in this period would not be thromboresistant.

A CLINICAL COMPARATIVE STUDY BETWEEN ANTERIOR ILIAC AND PROXIMAL TIBIAL METAPHYSIS PARTICULATED CANCELLOUS BONE GRAFTS (장골과 경골의 자가입자망상골 이식에 관한 임상적 비교연구)

  • Oh, Sung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.228-231
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    • 1998
  • This is a clinical and retrospective study of 36 patients received the autogenous particulated cancellous bone grafts from anterior iliac and proximal tibial metaphysis and we compared the clinical postoperative complications in operation sites and donor site morbidity. The results of this study indicate that, in all our patients, the proximal tibia provided an adquate volume of cancellous bone and there were no special contraindications, in choosing and using the proximal tibia as a donor site in most oral and maxillofacial cancellous bone graft surgeries. Furthermore, the proximal tibial metaphysis would appear a more easily obtainable cancellous bone source and offer a superior clinical results than anterior iliac crest in donor site morbidity.

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Surgical Treatment of Coronary Artery Occlusive Disease (관상동맥 협착증의 외과적 치험 -30례의 임상적 결과-)

  • 김병열
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.994-1000
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    • 1995
  • Thirty patients with ischemic heart disease underwent coronary artery bypass grafting [CABG from 1985 through 1994. There were 16 males and 14 females whose age ranged from 41 to 72 years old. Preoperative diagnoses were unstable angina in 13 of patients, stable angina in 8, postmyocardial infarction state in 7, and state of failed percutaneous transluminal coronary angioplasty [ PTCA in 2. The patterns of disease were single vessel involvement [ 17cases , double vessel involvement [ 7 cases , triple vessel involvement [ 3 cases , Lt main lesion including Lt. ostial lesion [ 3 cases . Saphenous vein grafts were used in 27/30 patients [ 90% , and internal mammary artery grafts were used in 6/30 patients [ 20% . The hospital mortality was 13.3% and all survivors were asymptomatic and improved over their preoperative status.

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First Results of the Single Heartstring Aortotomy for Multiple Off-Pump Vein Grafts: A Case Series

  • Santos, Rafael Freire dos;Niclauss, Lars
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.403-407
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    • 2020
  • To validate the technique of the single Heartstring aortotomy for multiple off-pump venous bypass grafts (described in 2015), the results of a 38-month follow-up study of 18 patients, including high-risk patients, are presented. No early deaths or cardiac or cerebral complications occurred. During the follow-up period, 2 patients died of non-cardiac causes, and 3 developed coronary ischemia. Ischemia occurred due to late graft occlusion in 2 patients, both of whom had normal postoperative courses and correct graft flow. The presence of acute symptoms 24 months after surgery in these patients indicated that technical graft failure was unlikely. This safe technique combines the advantages of simple and reproducible revascularization, the off-pump approach, and minimal aortic manipulation.

Minimally Invasive Redo Mitral Valve Replacement under Fibrillatory Arrest in a Patient with a Calcified Aorta and Patent Previous Bypass Grafts

  • Kim, Seung Hyun;Kim, Hak Ju;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.283-285
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    • 2018
  • A 73-year-old woman who underwent combined bioprosthetic mitral valve replacement, tricuspid ring annuloplasty, and coronary artery bypass grafting 12 years previously visited our clinic due to aggravated dyspnea caused by structural valve deterioration of the mitral prosthesis. Because aortic or femoral artery cannulation and cross-clamping would have a high risk of stroke owing to severe calcification of the ascending aorta and ilio-femoral vessels, and because there was a risk of redo sternotomy due to the patent bypass grafts, a comprehensive approach including axillary artery cannulation, a minimally invasive right thoracotomy approach, and a clampless hypothermic fibrillatory arrest technique was used during redo mitral valve replacement.

Endoscopic ACL Reconstruction Using A Quadrupled Semitendinosus Graft (4겹의 반건양근 건을 이용한 전방십자인대 재건술)

  • Lee, Kwang-Won
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.72-80
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    • 1997
  • Numerous techniques of anterior cruciate ligament (ACL) reconstruction have been described in literature. All have inherent advantages and disadvantages. The central one-third patellar tendon and hamstring tendons are the most commonly used autogenous tissues for replacement of a torn anterior cruciate ligament. Although the central one-third patellar tendon is considered to be 'the gold standard' for replacement of torn ACL. equivalent results have been reported using hamstring tendon grafts. Autogenous hamstring grafts provide adequate strength while avoiding donor site morbidity associated with bone-tendon-bone harvest. $EndoButton^{\circledR}$ femoral fixation allows precise femoral tunnel placement without a second incison. The purpose of this article is to describe surgical techniques using a quadrupled semitendinosus tendon and $EndoButton^{\circledR}$ fixation, and review the results of replacement of ACL.

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Development of Bioartificial Skin for Skin Regeneration (손상된 피부 재건을 위한 바이오인공피부의 개발 동향)

  • Seo, Young-Kwon;Song, Kye-Yong;Park, Jung-Keug
    • KSBB Journal
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    • v.23 no.1
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    • pp.8-17
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    • 2008
  • There are many different approaches to healing of acute and chronic ulcer and large skin defect, such as burn. Currently available wound covers fall into two categories. Permanent covering, such as autografts, and temporary ones, such as allograft including de-epidermized cadaver skin, bioartificial skin, xenografts, and synthetic dressings. Autologous skin grafting in the form of split- or full-thickness skin is still the good standard. Following on from developments in the 1980s involving the use of cultured keratinocyte grafts in wound healing, the last decade has been great progress in the fabrication of composite bioartificial skin grafts. However, two bottleneck on producing cultured bioartificial skin, whether of the simple epithelial cell sheet type, or the more complex composite type, continue to be the generation of sufficient keratinocytes cheaply and quickly and develop biocompatible dermal scaffolds. This article covers the development, clinical application, and current research directions associated with bioartificial skin.