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Abstract
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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Article info
Publication history
Received:
November 5,
1954
Footnotes
☆Upper end of graft is to the right in all figures of gross specimens in this paper.
☆☆All photomicrographs of vascular grafts in this paper are of longitudinal sections with the inner surface at the top.
Identification
Copyright
© 1955 Published by Elsevier Inc.
