Studies in thoracic aortic graft infections: the development of a porcine model and a comparison of collagen-impregnated dacron grafts and cryopreserved allografts
| Autor: | Mikhail Vaynblat, Peter Homel, Nuria M. Lawson, Joshua H. Burack, Paul Impellizzeri, Anthony J. Acinapura, Yong D. Kim, Joseph N. Cunningham, Norman M. Rowe, Marcel Sierra |
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| Rok vydání: | 1999 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Prosthesis-Related Infections Time Factors Swine medicine.medical_treatment Aorta Thoracic Bacteremia medicine.disease_cause Prosthesis Bolus (medicine) medicine.artery Ascending aorta medicine Thoracic aorta Animals Transplantation Homologous Prosthesis-Related Infection Cryopreservation business.industry Polyethylene Terephthalates Reproducibility of Results Staphylococcal Infections medicine.disease Surgery Blood Vessel Prosthesis surgical procedures operative Staphylococcus aureus Collagen Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. 118(5) |
| ISSN: | 0022-5223 |
| Popis: | Objective: A porcine model of thoracic aortic graft infection was created, and various anatomic sites and the timing of inoculation of the graft to induce infection were investigated. Ultimately, the ability of cryopreserved allograft to resist infection was compared with that of collagen-impregnated Dacron graft. Methods: Yorkshire pigs (n = 16) underwent placement of an expanded polytetrafluoroethylene patch graft in the ascending aorta and the left atrial appendage (phase I). Eight animals were immediately given a 50-mL bolus (1 × 10 8 cfu/mL) of Staphylococcus aureus whereas the other 8 received the infusion 24 hours later. Animals were put to death 8 weeks later and the grafts were sterilely explanted and analyzed via microbiologic culture and standard histologic procedures for evidence of infection. The results displayed that the aortic graft and a delay of induced bacteremia of 24 hours were more reliable methods of producing infection. During phase II, 13 pigs were randomized to receive either a collagen-impregnated Dacron graft (n = 6) or a cryopreserved allograft (n = 7) in the ascending aortic position only and infusion of S aureus 24 hours after the operation. The experiment then proceeded to completion. Results: Phase I results displayed that use of an aortic graft and induced bacteremia 24 hours after the operation was a more reliable and reproducible method of producing infection. In phase II, graft infection was present in 38.5% (5/13) of animals, with only 16.7% (1/6) in the collagen-impregnated Dacron graft group and 57.2% (4/7) in the cryopreserved allograft group becoming infected. There was no significant difference between the collagen-impregnated Dacron graft and cryopreserved allograft groups in the incidences of thoracic aortic graft infections ( P = .27, Fisher exact test). Conclusions: This novel porcine model of thoracic aortic graft infection is a reproducible method for the investigation of thoracic aortic graft infections. The phase I study investigated the timing of the induced bacteremia and the most susceptible position of a graft. Phase II demonstrated that collagen-impregnated Dacron grafts are equivalent, if not superior, to cryopreserved allografts in resisting central vascular graft infections in the ascending aorta. (J Thorac Cardiovasc Surg 1999;118:857-65) |
| Databáze: | OpenAIRE |
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