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

• 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
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.cir.0000087388.15066.1f

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