The Differential Response to Infection of Autogenous Vein versus Dacron Arterial Prosthesis

Bricker, Donald L.; Beall, Arthur C.; DeBakey, Michael E.

doi:10.1378/chest.58.6.566

Cited by 38 publications

(9 citation statements)

References 4 publications

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“…Second, its biological matrix can be remodeled by the body according to the needs of the environment. Third, the absence of synthetic material will preclude foreign body reaction, allow complete graft integration, limit graft infection, and may result in increased overall patency rates (14)(15)(16). In 1986, Weinberg and Bell (17) were the first to produce a completely biological TEBV from animal collagen gels and cultured bovine endothelial cells (ECs), smooth muscle cells (SMC), and fibroblasts.…”

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confidence: 99%

A completely biological tissue-engineered human blood vessel

et al. 1998

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Mechanically challenged tissue-engineered organs, such as blood vessels, traditionally relied on synthetic or modified biological materials for structural support. In this report, we present a novel approach to tissue-engineered blood vessel (TEBV) production that is based exclusively on the use of cultured human cells, i.e., without any synthetic or exogenous biomaterials. Human vascular smooth muscle cells (SMC) cultured with ascorbic acid produced a cohesive cellular sheet. This sheet was placed around a tubular support to produce the media of the vessel. A similar sheet of human fibroblasts was wrapped around the media to provide the adventitia. After maturation, the tubular support was removed and endothelial cells were seeded in the lumen. This TEBV featured a well-defined, three-layered organization and numerous extracellular matrix proteins, including elastin. In this environment, SMC reexpressed desmin, a differentiation marker known to be lost under standard culture conditions. The endothelium expressed von Willebrand factor, incorporated acetylated LDL, produced PGI2, and strongly inhibited platelet adhesion in vitro. The complete vessel had a burst strength over 2000 mmHg. This is the first completely biological TEBV to display a burst strength comparable to that of human vessels. Short-term grafting experiment in a canine model demonstrated good handling and suturability characteristics. Taken together, these results suggest that this novel technique can produce completely biological vessels fulfilling the fundamental requirements for grafting: high burst strength, positive surgical handling, and a functional endothelium.

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confidence: 99%

A completely biological tissue-engineered human blood vessel

et al. 1998

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“…After more than 300 vascular graft implants with nonsterile SIS in dogs, we have never observed graft failure caused by infection, nor have we observed clinical evidence of infection. Although reports of human clinical studies attest to the relative resistance of biologic grafts (such as autogenous saphenous vein) to infection compared with synthetic graft materials, 5 we have taken special notice of the resistance of SIS considering the obvious nonsterile source of the material (small intestine) and the fact that we have not subjected the SIS to any form of sterilization, other than transient soaking in 10% neomycin-saline solution, before implantation. The incidence of vascular graft infections in human medicine has decreased from approximately 8% to less than 2% with the advent of perioperative antibiotic use,6'1l but the consequences of infection are catastrophic and life-threatening.…”

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confidence: 99%

“…Synthetic vascular grafts, such as Dacron and expanded polytetrafluoroethylene (ePTFE) are approximately four times more likely to become infected than autogenous saphenous vein grafts. 5 These synthetic materials provide a site to harbor bacteria once an infection is established. In contrast, biologic materials, particularly those that are associated with revascularization of an anatomic region, seem to provide a microenvironment that inhibits or discourages bacterial growth.…”

mentioning

confidence: 99%

Comparison of the resistance to infection of intestinal submucosa arterial autografts versus polytetrafluoroethylene arterial prostheses in a dog model

Badylak¹,

Coffey²,

Lantz³

et al. 1994

Journal of Vascular Surgery

146

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“…However, vein grafts have been shown experimentally to have higher rates of necrosis than ePTFE when contaminated and they are susceptible to pseudoaneurysm formation and rupture. 18,19 An increasing body of literature regarding the use of prosthetic alternatives, particularly in the face of gastrointestinal contamination, has arisen, and ePTFE has been shown to be a viable option in some situations. 20 Although generally less pronounced in autogenous vein grafts, NH is known to be a significant long-term problem in both types of conduits.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Bacterial Contamination on Neointimal Hyperplasia in Vascular Grafts

Edwards

Claridge

Shell

et al. 2006

The American Surgeon™

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Neointimal hyperplasia (NH) is the most significant contributing factor to long-term vascular graft failure. Inflammation is known to be important in its development; however, the role of bacterial infection is unclear. We examined the effect of contamination with common organisms on the development of NH in expanded polytetrafluoroethylene grafts. Thirty adult pigs were randomized into one of four groups: no infection, contamination with Staphylococcus aureus, mucin-producing Staphylococcus epidermidis, or Pseudomonas aeruginosa. An expanded polytetrafluoroethylene graft (6 mm x 3 cm) was placed as a common iliac artery interposition graft and was inoculated with 1–2 x 108 of the selected organism before closure. Grafts were explanted 6 weeks postoperatively. Microbiologic, histological, and morphometric evaluations were performed. All grafts were patent at the time of euthanasia. The mean areas of NH were 5.45 mm2 in sterile grafts, 8.36 mm2 in S. aureus, 7.63 mm2 in S. epidermidis, and 11.52 mm2 in P. aeruginosa grafts. Comparison of means via analysis of variance showed that P. aeruginosa grafts had significantly higher formation of NH than sterile grafts (P = 0.025). NH production in infected grafts appears to be organism specific and is significantly higher with P. aeruginosa than common Gram-positive organisms. Increased NH from subclinical infection may be a significant factor contributing to late graft failures.

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The Differential Response to Infection of Autogenous Vein versus Dacron Arterial Prosthesis

Cited by 38 publications

References 4 publications

A completely biological tissue-engineered human blood vessel

A completely biological tissue-engineered human blood vessel

Comparison of the resistance to infection of intestinal submucosa arterial autografts versus polytetrafluoroethylene arterial prostheses in a dog model

The Effect of Bacterial Contamination on Neointimal Hyperplasia in Vascular Grafts

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