BACKGROUND: Tracheal reconstruction after extensive resection remains a challenge in thoracic surgery. The goal of this experimental study was to analyze the long-term evolution of tracheal replacement using an autologous aortic graft. METHODS: In 21 @entity742 , a 5-cm segment of the cervical @entity825 was replaced by a segment of the descending thoracic aorta that was reconstructed to a prosthetic graft. Because of the airway collapse reported in a previous series, a permanent (n = 13) or temporary (n = 8) stent was systematically placed in the lumen of the graft. Clinical, bronchoscopic, and histologic examinations were performed up to 3 years after implantation. RESULTS: All animals survived the operation with no @entity451 . In the group with a permanent stent, three complications occurred: one stent displacement, one @entity4 , and one @entity281 . Stent removal was tolerated after 6 months in the group with a temporary stent. Histologic examination showed a progressive transformation of the arterial segment into first extensive inflammatory tissue with a squamous epithelium, and after 6 to 36 months well-differentiated tracheal tissue including a continuous mucociliary epithelium and regular rings of newly formed cartilage. CONCLUSIONS: An autologous aortic graft used as a substitute for extensive tracheal replacement in @entity742 remained functional for periods up to 3 years. The progressive transformation of the graft into a structure resembling tracheal tissue seems to be a key factor in long-term patency. The mechanism of this regenerative process and the possibility of using arterial homografts, which would make clinical application easier, remain to be evaluated.

Long-term evaluation of the replacement of the XXXX with an autologous aortic graft.

@entity825 :: ('MESH:D055090', 'Disease') :: ['trachea'] @entity742 :: ('9940', 'Species') :: ['sheep'] @entity4 :: ('MESH:D004487', 'Disease') :: ['laryngeal edema'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection'] @entity451 :: ('MESH:C536857', 'Disease') :: ['paraplegia']
@entity825 :: (MESH:D055090,Disease) :: ['trachea']
