Experimental Replacement of Pig Trachea with Novel Bioprosthesis from Harp Seal

Abstract

Tracheal replacement has been a challenging problem for thoracic surgeons for over half of a century. We evaluated the in-vivo performance of a new tracheal bioprosthesis derived from Harp seal (Phoca groelandica) trachea that was fixed and preserved in 0.625% buffered glutaraldehyde solution for 3 months. Ten young male pigs weighing 27-32 kg (mean, 28.7 kg) underwent replacement of a tracheal segment with this new bioprosthesis. The length of replaced trachea was 1.8-2.4 cm (mean, 2.17 cm), representing 2-3 cartilage rings. All pigs survived the operation uneventfully. No immunosuppression drugs were used. The pigs eventually developed dyspnea and were euthanized on postoperative day 17-39 (mean, 30.8 days). Macroscopic and histological analysis showed an intact bioprosthesis but near-total occlusion of the native trachea by a ring of inflammatory infiltration at the site of distal anastomosis. More experiments involving a different concentration of the preservation agent, different management, and perhaps the use of bioengineering techniques are needed to improve the performance of this novel bioprosthesis.