Experimental Carinal Replacement with an Y-Shaped Collagen-Conjugated Prosthesis

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Abstract
Background: A new prosthesis was designed for reconstruction of the bifurcation of the trachea and used for experimental carinal replacement in dogs. Methods: The main Frame of the new prosthesis consists of Y-shaped Marlex mesh tube reinforced with polypropylene spirals. It is coated with collagen extracted from porcine skin to provide biocompatibility and airtightness. Carinal replacement with omentopexy was performed in 17 dogs. Results: Seven dogs survived the postoperative period, and 10 dogs died within 11 days after the operation. The main causes of early postoperative death were fistula and air leakage from the prosthesis. Causes of late postoperative death were obstruction of the main bronchus (two) and lung abscess (one). The four long-term survivors had no stenosis or dehiscence until they were sacrificed 15 months after the operation. Histological examination of these dogs revealed that the luminal surface was covered either with ciliated columnar epithelium or non-ciliated squamous epithelium. Conclusions: The study results suggest the possibility of successful prosthetic carinal reconstruction with epithelial regrowth using this Y-shaped prosthesis.

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