Name: surgical technique for the implantation of tissue engineered vascular grafts and subsequent in vivo monitoring
Uploaded: 2015-04-03T13:00:00
Description: Watch this Scientific Journal Video about Surgical Technique for the Implantation of Tissue Engineered Vascular Grafts and Subsequent In Vivo Monitoring at JoVE.com

Dette arbeidet ble støttet med tilskudd fra National Heart and Lung Institute (R01 HL086582) og New York Stem Cell Science Fund (NYSTEM, Contract # &#160; C024316) til STA og DDS Illustrasjonene som brukes i Jove video ble gjennomført av John Nyquist; Medisinsk Illustrator fra State University of New York i Buffalo.

MERK: Denne protokollen er godkjent av Animal Care og bruk komité ved State University of New York i Buffalo. 1. Pre-kirurgisk Forberedelse <ol><li> Bruk sau (Dorset kors, kvinne, ca 1-3 år gammel med en vekt på 40-60 kg) for følgende studie. Administrere cyklosporin A (200 mg / dag), aspirin (975 mg / dag), og coumadin (20-30 mg / dag) oralt, med start 3 dager før kirurgi, og fortsetter så lenge alle studier. </li><li> Sikre sauene har fastet 12 timer før kirurgi (normal fôr = 1,8...

<ol>
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A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+completely+biological+tissue-engineered+human+blood+vessel.">A completely biological tissue-engineered human blood vessel.</a> The FASEB Journal. 12, 47-56 (1998).</li><li>Samaha, F. J., Oliva, A., Buncke, G. M., Buncke, H. J., Siko, P. 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Hensikten med denne rapporten er å gi en pålitelig og reproduserbar prosedyre til implantat TEVs av interesse i sau halspulsåren. De innfødte carotis av dyrene som brukes i denne modellen var 0,5-0,75 mm i tykkelse og 4,5-5 mm i utvendig diameter. Den kirurgiske teknikken beskrevet her har vært vellykket for å implantere TEVs av varierende geometrier som måler 0,25 til 1 mm i tykkelse, 4-5 mm utvendig diameter og 4 cm i lengde med stor suksess beviser effektiv opp til 3 måneders varighet, den tiltenkte sluttpunk...

Det primære fokus for utvikling av TEVs har vært å gi en erstatning for autolog pode erstatning når autologe fartøy er ikke tilgjengelig, og å begrense donor syn sykelighet. For eksempel har antallet hjerte bypass operasjoner per år oversteg 350.000 i USA, og den ideelle kilden til egnede grafts forblir den venstre indre brystarterie, venstre fremre nedstigende koronar og saphenavene en. Siden mange personer som lider av vaskulære sykdommer ikke kan ha egnede arterier og vener for autolog pode erstatning, har utviklingen av TEVs dermed bli en intens forskningsfelt i flere tiår 1-6. Mens ingeniør- og optimalisering av nye TEVs har gjennomgått mange fremskritt, rapportering på de kirurgiske teknikker ansatt for å implantere de TEVs seg selv har ikke vært et tema for en slik intens diskusjon. Snarere er protokoller vedrørende implantasjon av TEVs i dyremodeller hovedsakelig venstreopp til forskning etterforskere. Følgende manuskript demonstrerer hvordan å implantere TEVs ved å utnytte en ende-til-ende-anastomose tilnærming. Denne prosedyren ble optimalisert ved bruk av en spesifikk anastomotisk suturering mønster, stabiliserende sutur teknikk, å optimalisere langsgående strekk, og tilsetningen av in vivo overvåkning instrumentering. Denne metode er i motsetning til noen av de mange variasjoner som tidligere har blitt benyttet. Videre beskriver denne fremgangsmåten hvordan å skaffe parametre slik som arterielt blodtrykk, TEV diameter / compliance og strømningshastighet gjennom TEV etter operasjonen inntil explantation. Denne datainnsamlingen gir en uunnværlig analyse av TEV mens den er i ferd med ombygging.

<table border="0" cellpadding="0" cellspacing="0" width="1505">
	<tbody>
		<tr height="43">
			<td dir="LTR" height="43" style="height:43px;width:335px;">Equipment</td>
			<td dir="LTR" style="width:208px;">Manufacturer</td>
			<td dir="LTR" style="width:311px;">Serial/Catalog #</td>
			<td dir="LTR" style="width:363px;">Notes</td>
		</tr>
		<tr height="56">
			<td dir="LTR" height="94" rowspan="2" style="height:94px;width:335px;">Pressure Transducer</td>
			<td dir="LTR" rowspan="2" style="width:208px;">Becton Dickinson</td>
			<td dir="LTR" rowspan="2" style="width:311px;">P23XL-1</td>
			<td dir="LTR" style="width:291px;">1+ (1 for each artery) 
			&#160;Used with water-filled diaphragm domes</td>
		</tr>
		<tr height="172">
			<td dir="LTR" height="172" style="height:172px;width:335px;">Amplifier and transducer box</td>
			<td dir="LTR" style="width:208px;">Gould</td>
			<td dir="LTR" style="width:311px;">5900 Signal Conditioner Cage</td>
			<td dir="LTR" style="width:291px;">1 
			Two transducers and amplifiers should be included in cage. While this specific unit may be discontinued, other commercially available pressure transducers with a BNC/analog output will communicate with the Sonometrics equipment</td>
		</tr>
		<tr height="121">
			<td dir="LTR" height="121" style="height:121px;width:335px;">T403 Console with TS420 perivascular flowmeter module(x2)&#160;</td>
			<td dir="LTR" style="width:208px;">Transonic Systems</td>
			<td dir="LTR" style="width:311px;">T403 module and TS420 (x2)</td>
			<td dir="LTR" style="width:291px;">1 
			Flow probes measuring flow through each of the carotid arteries will connect to each of the TS420 units.&#160;&#160;</td>
		</tr>
		<tr height="126">
			<td dir="LTR" height="126" style="height:126px;width:335px;">Digital ultrasonic measurement unit</td>
			<td dir="LTR" style="width:208px;">Sonometrics</td>
			<td dir="LTR" style="width:311px;">TR-USB</td>
			<td dir="LTR" style="width:291px;">1</td>
		</tr>
		<tr height="48">
			<td dir="LTR" height="48" style="height:48px;width:335px;">Flow Probe Precision S-Series 4mm</td>
			<td dir="LTR" rowspan="4" style="width:208px;">Transonic Systems Inc.</td>
			<td dir="LTR" rowspan="4" style="width:311px;">MC4PSS-LS-WC100-CM4B-GA</td>
			<td dir="LTR" rowspan="4" style="width:291px;">2</td>
			<td dir="LTR" rowspan="4" style="width:363px;"></td>
		</tr>
		<tr height="24">
			<td dir="LTR" height="49" rowspan="2" style="height:49px;width:335px;">1mm&#160; Sonometrics Crystals</td>
			<td dir="LTR" rowspan="2" style="width:208px;">Sonometrics Systems</td>
			<td dir="LTR" rowspan="2" style="width:311px;">1R-38S-20-NC-SH</td>
			<td dir="LTR" style="width:291px;">&#160;2-4 (2 for each artery)</td>
		</tr>
		<tr height="81">
			<td dir="LTR" height="134" rowspan="2" style="height:134px;width:335px;">Catheter for implantation</td>
			<td dir="LTR" style="width:208px;">BD (Becton Dickinson)</td>
			<td dir="LTR" rowspan="2" style="width:311px;">&#160;381447</td>
			<td dir="LTR" style="width:291px;">&#160;1+ (1 for each artery) 
			Catheter is cut and secured to microbore tubing, stylette is utilized for insertion&#160;</td>
		</tr>
		<tr height="24">
			<td dir="LTR" height="73" rowspan="2" style="height:73px;width:335px;">Tygon Microbore Tubing</td>
			<td dir="LTR" rowspan="2" style="width:208px;">Norton Performance Plastics</td>
			<td dir="LTR" style="width:311px;">(AAQ04127) Formulation S-54-HL</td>
			<td dir="LTR" style="width:291px;">NA (cut to length for an extension set)</td>
		</tr>
		<tr height="24">
			<td dir="LTR" height="49" rowspan="2" style="height:49px;width:335px;">Luer Stub Adapter</td>
			<td dir="LTR" style="width:208px;">BD (Becton Dickinson)</td>
			<td dir="LTR" style="width:311px;">427564 (20 gauge)</td>
			<td dir="LTR" style="width:291px;">1+ (1 for each arterial catheter)</td>
		</tr>
		<tr height="24">
			<td dir="LTR" height="82" rowspan="2" style="height:82px;width:335px;">Surflo Injection Plug</td>
			<td dir="LTR" rowspan="2" style="width:208px;">Terumo</td>
			<td dir="LTR" rowspan="2" style="width:311px;">SR-IP2</td>
			<td dir="LTR" style="width:291px;">1+ (1 for each arterial catheter)</td>
		</tr>
		<tr height="39">
			<td dir="LTR" height="128" rowspan="2" style="height:128px;width:335px;">Meadox</td>
			<td dir="LTR" rowspan="2" style="width:208px;">PTFE (Teflon) Felt</td>
			<td dir="LTR" rowspan="2" style="width:311px;">19306</td>
			<td dir="LTR" style="width:291px;">NA (cut to size) 
			The PTFE felt used in our studies was discontinued. However, comparable companies such as &#8220;Surgical Mesh&#8221; offer products which are equivalent.&#160;</td>
		</tr>
	</tbody>
</table>

surgical technique for the implantation of tissue engineered vascular grafts and subsequent in vivo monitoring

Utviklingen av vev konstruert fartøy (TEVs) føres frem ved evnen til å rutinemessig og effektivt implantat TEVs (4-5 mm i diameter) inn i en stor dyremodell. Et trinn for trinn protokoll for inter-posisjonsplassering av TEV og sanntids digital vurdering av TEV og innfødte carotis er beskrevet her. In vivo overvåkning er gjort mulig ved implantering av strømnings sonder, katetre og ultrasoniske krystaller (stand med å samle inn dynamiske diameter endringer av implanterte TEVs og innfødte carotis) på tidspunktet for kirurgi. Når implantert, kan forskerne beregne arterielle blodstrømningsmønster, invasiv blodtrykk og arterie diameter givende parametere som puls bølgehastighet, styrking indeks, pulstrykk og etterlevelse. Datainnsamlingen blir oppnådd ved hjelp av en enkelt datamaskin-program for analyse i løpet av varigheten av eksperimentet. Slik uvurderlig data gir innsikt i TEV matrise ombygging, sin resemblance til morsmålsopplæring / humbug kontroller og generell TEV ytelse in vivo.

Mer enn 30 sauer har gjennomgått den kirurgiske teknikken som er beskrevet i denne rapporten for implantering av TEVs (i pressen) 9. En tabell som oppsummerer de nyligste sauer operasjoner etter protokoll optimalisering er vist i tabell 2. Alle sauene gjenvunnet etter TEV implantasjon uten livstruende komplikasjoner. I noen dyr, ble fibrose observert i native arterie nær spissen av den iboende arteriekateter. En betydelig økning av inflammasjon med tilstedeværelse av tilsatt instrumenteri...

Watch this Scientific Journal Video about Surgical Technique for the Implantation of Tissue Engineered Vascular Grafts and Subsequent In Vivo Monitoring at JoVE.com

Surgical Technique for the Implantation of Tissue Engineered Vascular Grafts and Subsequent In Vivo Monitoring

En trinn-for-trinn-protokollen for den inter-posisjon plassering av Tissue Konstruert Vessels (TEVs) i halspulsåren av en sau ved hjelp av ende-til-ende-anastomose og real-time digital vurdering in vivo til dyreoffer.

Kirurgisk teknikk for Implantasjon av Tissue Engineered vaskulære implantater og Følgende<em&gt; I Vivo</em&gt; Overvåking

The development of Tissue Engineered Vessels (TEVs) is advanced by the ability to routinely and effectively implant TEVs (4-5 mm in diameter) into a large ...

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Bioengineering

Surgical Technique for the Implantation of Tissue Engineered Vascular Grafts and Subsequent In Vivo Monitoring

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