Topical VEGF enhances healing of thoracic aortic anastomosis for coarctation in a rabbit model

Recurrent stenosis after extended end-to-end anastomosis for aortic coarctation is the primary indication for further interventions in children. Tension because of the extended resection and local arterial wall hypoxia are possible pathogenetic mechanisms. We hypothesized that (1) tension interferes...

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Published in:Circulation (New York, N.Y.) N.Y.), 2003-09, Vol.108 (10), p.150-154
Main Authors: SEIPELT, Ralf G, BACKER, Carl L, MAVROUDIS, Constantine, STELLMACH, Veronica, SEIPELT, Ingrid M, CORNWELL, Mona, HERNANDEZ, Jose, CRAWFORD, Susan E
Format: Article
Language:English
Subjects:
Administration, Topical
Anastomosis, Surgical
Animals
Aorta, Thoracic - surgery
Aortic Coarctation - drug therapy
Aortic Coarctation - pathology
Aortic Coarctation - surgery
Biological and medical sciences
Combined Modality Therapy
Constriction, Pathologic - prevention & control
Endothelial Growth Factors - administration & dosage
Endothelial Growth Factors - therapeutic use
Intercellular Signaling Peptides and Proteins - administration & dosage
Intercellular Signaling Peptides and Proteins - therapeutic use
Lymphokines - administration & dosage
Lymphokines - therapeutic use
Male
Medical sciences
Rabbits
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Vascular Endothelial Growth Factor A
Vascular Endothelial Growth Factors
Wound Healing
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Summary:Recurrent stenosis after extended end-to-end anastomosis for aortic coarctation is the primary indication for further interventions in children. Tension because of the extended resection and local arterial wall hypoxia are possible pathogenetic mechanisms. We hypothesized that (1) tension interferes with healing and (2) that vascular endothelial growth factor (VEGF), a hypoxia sensitive angiogenic inducer, may enhance healing of the vascular anastomosis. In a model of coarctation repair, rabbits underwent thoracic aortic end-to-end anastomosis after transection (no-tension; n=15), resection of an aortic ring (tension; n=14) or resection and topical VEGF treatment (0.75 microg VEGF165; tension+VEGF; n=14). Gross and histologic characteristics of the aortic wall were assessed at 1 week, 1 and 2 months. In the tension only group at 1 month, the severity of vascular remodeling was increased with fibrosis and calcification compared with controls. At 2 months, this group also revealed more luminal stenosis (29% versus 19%; P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.0000087388.15066.1f