Authors : Julius M. Liptak , Peter T. Chin , Michael S. Stephen , Edward J. Wills and Geraldine B. Hunt
Abstract: The aim of this study was to evaluate the mesothelial-lined internal sheath of the rectus abdominus muscle (IRAS), with and without glutaraldehyde fixation and postoperative acetylsalicylic acid administration, as an autogenous interpositional graft of the prerenal caudal vena cava in clinically normal dogs. The IRAS was harvested from the right abdominal wall, tubularized with the mesothelial surface forming the luminal surface of the graft and then placed as an interpositional segmental graft in the prerenal caudal vena cava. In three dogs, the graft was fixed in glutaraldehyde and acetylsalicylic acid was administered in the postoperative period. In the remaining three dogs, the graft was not fixed and adjunctive treatment was not administered. Ultrasound and angiography were used to evaluate patency of the caval grafts following surgery and every 7 days for a maximum of 21 days. Dogs were euthanatized prior to 21 days if graft occlusion was evident on imaging studies or 21 days if the graft was patent. Endothelialization of the luminal surface of the graft was assessed by gross examination at necropsy and histologic and immunohistochemical analysis. One untreated and all three glutaraldehyde-fixed autogenous grafts remained patent for 21 days. Two untreated grafts, both non-isodiametric, thrombosed by 7 days. Histologic and immunohistochemical analyses showed mesothelial cells did not survive on the graft surface and endothelialization was only apparent in patent grafts. The IRAS is a readily available source of autogenous tissue, but untreated grafts have a low patency rate and graft fixation in glutaraldehyde and postoperative treatment with acetylsalicylic acid may be required to improve the patency rate of venous grafts in large veins such as the caudal vena cava.
Julius M. Liptak , Peter T. Chin , Michael S. Stephen , Edward J. Wills and Geraldine B. Hunt , 2007. Segmental Reconstruction of the Caudal Vena Cava Using an Autogenous Tubular Graft of the Internal Rectus Abdominus Sheath: A Pilot Study . Veterinary Research, 1: 1-11.