Research Article| Volume 38, ISSUE 6, P1090-1131, December 1955

The healing and fate of arterial grafts

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      The material of this paper consists of 230 grafts implanted in 170 animals (153 young pigs and 17 mature dogs). Studies have been made in the arterial system of the healing and fate of arterial autografts, homografts, and heterografts, of venous autografts, and of segments of the host aorta from which the inner wall has been removed; and in both the arterial and musculofascial systems of the healing and fate of Orlon cloth prostheses. On the basis of these studies we suggest that the healing of arterial grafts is the same as that of other tissues that do not regenerate specialized elements. The basic pattern of arterial graft healing consists in the ingrowth of fibrous elements from the contiguous arterial and periarterial tissues into the graft. The end results observed with different types of grafts varies widely. However, these differences are explainable on the basis of whether the cellular viability and fiber continuity of the original graft are maintained or not. The healing pattern of Orlon cloth prostheses used to span aortic gaps is the same as that of Orlon cloth prostheses used to bridge musculofascial defects. In each instance the cloth presents a stable wall which is healed by the ingrowth of fibrous elements from the surrounding tissues through its mesh. The host aorta from which the inner wall has been removed heals by migration to the inner surface and proliferation there of mural fibroblasts.
      Arterial autografts were observed to be perfect grafts. Fresh venous autografts implanted in arteries receiving good support from surrounding musculofascial tissues were observed to persist as viable, anatomically intact structures which were not subject to aneurysmal dilatation. Arterial homografts were observed to be resistant to aneurysm formation, unable to respond to growth stimulation, and liable to calcification. Arterial heterografts, differing from homografts, were observed to be unstable and prone to aneurysm formation and rupture. Orlon tubes were observed to be resistant to aneurysm formation, but prone to wrinkling and liable to calcification. The denuded inner wall of the host aorta was observed to heal quickly and to have little tendency toward mural thrombosis.
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