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Eur J Cardiothorac Surg 1998;14:615-620
© 1998 Elsevier Science NL

High doses of hydrocortisone improved tracheal autograft revascularization¹

Department of General Thoracic Surgery, Medical University of Gdansk, Gdansk, Poland

Received 29 November 1997; received in revised form 13 May 1998; accepted 7 July 1998.

Corresponding author. Department of General Thoracic Surgery, Medical University of Gdansk, 80-211 Gdansk ul. Debinki 7, Poland. Tel. +48-58-461194; Fax: +48-58-461194.

Objective: Anti-inflammatory effects of steroid to revascularization of the tracheal autografts in pigs, with the use of pedicled muscle flaps of the abdominal rectus was evaluated. Methods: The research was done on 19 pigs. First group: eight pigs, no steroids were given. Second group: 11 pigs, a daily dose of 30 mg/kg hydrocortisone was given, starting on the day of operation. A segment of trachea ten rings long was skeletonized and excised, and reimplanted in the previous position. A muscle flap was sutured on the anterior aspect of the tracheal autograft. Results: All eight animals in the first group died from graft failure. In the second group receiving steroids, only two animals succumbed (18.1%). Nine animals recovered, and were put to sleep 30–42 days following surgery. The average diameter of the grafts was 85%. Microscopically, all structures of the trachea were preserved. Grafts perfusion was on average 80.6%. Conclusions: Two conditions have to be fulfilled for tracheal autografts to survive: One, well vascularising muscular flaps have to be employed, and second, a high dose of steroids must be given starting on the day of operation.

Key Words: Tracheal grafts revascularization • Steroids • Muscle flap