J.Jpn. Surg. Soc.. 56(4): 517-537, 1955
EXPERIMENTAL STUDIES ON THE TRANSPLANTATION OF THE THORACIC DESCENDING AORTA
|
Surgical Department, Yokohama University School of Medicine (Director: Prof. Yamagishi) Rintaro YANO |
1) Changes following the obstruction of the thoracic descending aorta.
The blood flow interrupted by obstruction streams into the peripheral part of the thoracic descending aorta from the obstructed portion through the internal thoracic arteries and the intercostal arteries.
As the results of the measurement of blood gas contents in the arterial and venous system of the peripheral part, oxygen deficiency and decrease of the reserved alkali were demonstrated. In the central part from the obstructed portion, acidosis was not always demonstrated and sometimes rather alkalosis can be present. Carbonic acid gas vol % in blood was gradually decreased after the obstruction was made.
E.K.G. showed the depression of ST wave directly after the obstruction was made and removed. If the obstruction was continued over 20 minutes ST wave became flat, but such changes were temporary and reversible if the obstruction was removed within about 30 minutes.
Pathological findings revealed the degeneration of the spinal cord at the part where corresponds to the scope under the obstructed portion if the interruption of the blood flow continued over 25 minutes.
Liver cells showed the central necrosis. Especially, by PAS staining, histological changes of the liver were shown more clearely.
According to these facts, the author suggests that the interruption of the blood stream at the thoracic descending aorta should not be continued over 30 miuntes, and must be careful about the secondary shock and other factors in such conditon.
2) The author observed the histological changes of vessels at the portion where the anastomosis was performed and the transplanted graft by the hour after operation.
It needs about 1 month after operation to get a safty and tight connection at the anastomosis portion.
Comunication of the vessel advanced to the media from the adventita and the intima.
Elastic fibre was thin and it was able to be found even 1 year after operation.
New formation of the elastic fibre of the transplanted graft was not recognized in 2 dogs that had been survived for 1 year after operation.
In one of these dogs, the anastomosis portion was observed by aut psy.
At the anastomosis portion, the extremity of the vessel shifted smoothly to the transplanted graft.
Elasticity of the graft slightly reduced, wall of the vessel was slightly thin and its intima seemed to be slightly pale.
The author, further, studied on the selection of the graft and on a method of its preservation.
3) The author confirmed that the transplantation of the thoracic descending aorta is possible, if we pay attention to the points mentioned above.
(author's abstract)
To read the PDF file you will need Adobe Reader installed on your computer.