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Biomedical subjects

R Guidoin

Publications and source records attributed to R Guidoin.

At least 181 records · Page 10Linked to original sources
PubMed1980

Defibrinogenation as an alternative to heparinization in prolonged extracorporeal circulation.

Complications arising from difficulty controlled bleeding and thrombus formation during procedures which require extracorporeal circulation with heparin as anticoagulant motivate the search for better hemostasis and anticoagulant technology. An enzyme (Defibrase), having a specific interaction with fibrinopeptide A such as to cause fibrin depletion in a soluble form, has been proposed as an alternative to heparin. Defibrase, in contrast to heparin, does not affect blood platelet function. Heparin and Defibrase as anticoagulants were compared in 8 h perfusion studies using arterio-venous extracorporeal blood circuits in dogs; the circuitry included pumps, membrane oxygenators and filters serially. Thrombus formation, in the filters and the oxygenators as well as pathology of the perfused animal were investigated. The results suggest that defibrase-like enzymes have potential for enhanced control of hemorrhagic and thrombotic phenomena. Although impeded by a latency of several hours before the full anticoagulant properties are developed in vivo, it appears that enzymatically mediated defibrinogenation of blood may be a valuable alternative to heparinization in extracorporeal circulation procedures.

Animals↗
PubMed1980

Processes human umbilical veins as arterial substitutes--evaluation in canine models.

Human umbilical cord vein segments have been used as vessel substitutes for damaged or occluded arteries, as aorto-coronary by-passes and as arterio-venous fistulae for dialysis. The Dardik-Biograft fixed with glutaraldehyde and the Mindich-Bioflow, fixed with ethanol and dialdehyde starch, are commercially available. They were implanted in dogs as replacements for a segment of the abdominal aorta. Post-implantation status was followed by angiography. They were evaluated after removal from sacrificed animals with the aid of scanning electron microscopy and histological techniques. Attention was focused on vessel patency, dimensional stability, integrity of the anastomosis line, lumen wall microstructure, evidence of suture damage and thrombus deposition pattern. Both types of grafts gave functional by-passes for at least until 6 months post-implantation. The Dardik-Biograft appeared more prone to thrombus formation near the anastomosis. Sparse cellular development was also noted. The Mindich-Bioflow gave rise to a prosthesis of superior thromboresistance which was more subject to mechanical damage.

Animals↗
PubMed1980

Another look at the Sparks-Mandril arterial graft precursor for vascular repair. - Pathology by scanning electron microscopy.

The Sparks-Mandril blood vessel precursor system, an autogenous tissue growth-promoting device, in spite of its ingenuity and its surgical elegance, has received only limited usage. At technique for peripheral blood vessels by several authors. In the latter period, this laboratory also undertook similar work. The results of seven implantations in dogs and two in patients are reported here in the context of a program on the evaluation of blood vessel substitutes, their mode of operation and their long term performance. The clinical status and the pathology of the grafts at time of failure were investigated using techniques of scanning electron microscopy. This work confirms the findings of other centres regarding the generally unsatisfactory performance of the Sparks-Mandril system. Possible causes for failure in mandril-formed blood vessels are discussed.

Adult↗
PubMed1980

In vitro performance assessment of tubular membrane oxygenators.

The definite advantage in oxygen transfer performance of staged (single, double and triple) tubular membrane oxygenators (TMO) is compared with reference to flat membrane oxygenators (Travenol or Landé Edwards). The overall construction of staged TMO with a blood mixing chamber is a very good way to destroy the blood boundary layer and modify the blood stagnant zone in the device. Four sizes of staged TMO were studied using the principle that gases dissolve in water in concentrations linearly proportional to the partial pressures of the gases when in equilibrium with the liquid. The experimental results show that the oxygen transfer rate and the corresponding overall oxygen mass transfer coefficient of staged TMO are increased by the same order as those of the reference membrane oxygenators. Furthermore the essential parameter analysis prove that oxygen transfer increases with the number of stages and decreases with the length of the blood tubular modules. The multistage design of TMO revealed an increase in the hydrodynamic resistance occurring in the apparatus. However the highest relative oxygen transfer efficiency suggests that better fluid distribution as well as better uniformity of oxygenation prevail in the staged devices.

Evaluation Studies as Topic↗
PubMed1980

[Polyethylene terephtalate (Dacron) prostheses as arterial substitutes. Value of commercial grafts as abdominal aorta substitutes in the dog (author's transl)].

Most of the presently available Dacron fabric grafts are either woven or knitted; some are velours. Whereas the various configurations and textures can be easily recognized and classified with respect to morphology, structure, porosity and fabric tenacity, it is also necessary to establish their post-implantation healing characteristics. Canine models have been used to investigate the healing characteristics of 18 types of prostheses over implantation periods from one to six months using techniques of scanning electron microscopy and conventional light microscopy. Velours exhibit superiar tissue ingrowth but the internal tissue lining does seldom embeds all of the fibres. Complete neoendothelialization is not achieved; the process appears more closely linked to haemodynamic factors such as shear forces acting postfacto on blood deposits as opposed to graft porosity facilitating ingrowth. More meaningful criteria of performance must be found to allow a closer matching between the available products and the individual clinical needs of each situation.

Animals↗
PubMed1980

Cardiovascular sutures as assessed by scanning electron microscopy.

Nine types of commercial sutures were investigated with respect to their suitability in cardiovascular surgery involving anastomosis of arterial prostheses. Polyester, nylon, silk and polypropylene in the form of multifilaments and monofilaments with or without coatings were included. The gross structure of the suture and the needle, the uniformity of the fibres and the coatings, the mechanical properties, before and after surgical use and the quality of the resulting anastomoses in canine models were evaluated. Although all surveyed products were potentially usable for the purpose intended, some appeared more suitable. Intraoperative damage to the sutures was found to be extensive and may play an important part in the long-term security of the anastomoses.

Cardiac Surgical Procedures↗
PubMed1980

A SEM investigation of the trauma to prostheses and arteries during vascular reconstruction procedures.

Scanning electron microscopy was used to diagnose incidents of trauma and the pattern of healing following surgical implantation of microporous blood vessel substitutes. Vascular reconstruction procedures using autogenous or synthetic prosthetic materials inflict damage to the adjacent tissues as well as the prosthesis. This effects the thrombotic behavior and healing pattern of the area. The prognoses for long term success are, as a consequence, directly influenced. Various vessel occluding devices were evaluated on canine models with respect to their ability to damage blood vessels at the clamped site. The impact of suture needles on tissues and prosthetic materials was also considered. Of the various vessel clamping devices which are commercially available, those which have elastomeric shields on the clamping components were found to be the most satisfactory. The development of less traumatic surgical devices and possible modifications in the surgical protocols are discussed with the aim of further reducing surgical trauma.

Animals↗
PubMed1980

[Evaluation of two commercial bovine vascular heterografts (author's transl)].

Two commercially available grafts made from chemically modified bovine carotif arteries, Artegraft (Surgikos Corp. U.S.A.) and Solcograft (Solco A.G. Switzerland), were evaluated. Preliminary evaluation indicates that these products compare favorably with other more common chemically treated grafts of biological origin. Morphological characteristics, inflammatory response and thrombogenic potential were measured. Their structure suggest that each of the processes conserve the collagen morphology of the media and the adventitia originally present in the precursor arteries. Test implantations in dogs reveal a tendency to undergo stenosis near the anastomoses within a few months. After six months of in-vivo function, these grafts are not invaded with the expected neo-formed cells and new collagen in their central portion; this process takes place only near the anastomoses.

Animals↗
PubMed1978

Scanning electron microscope study on flat type membrane oxygenator after prolonged extracorporeal circulation.

Despite adequate anticoagulation, thrombi may develop onto any foreign surface subjected to circulating blood. Although the efficiency of membrane oxygenators can decrease, distal embolization can be more critical and dangerous. Scanning electron microscope observations carried out on the Travenol Modulung oxygenator used both on dogs and on patients for prolonged partial cardiopulmonary by-pass pointed out the following observations. Caution must be observed when translating the results from dogs to human beings. Heparin management can be delicate and critical. The problem of blood transfusion can be extremely important and must be extensively investigated.

Adult↗
PubMed1978

Endothelial lesions associated with vascular clamping--surface micropathology by scanning electron microscopy.

The endothelial cell pavement in normal blood vessels is very fragile. In cardiovascular surgery, the need for secure clamping of the aorta results in trauma which may be followed by thrombosis or occlusion. Various types of vascular clamps and other related devices offered commercially were clinically investigated in canine models and their effects on the vascular endothelium were ascertained with the aid of scanning electron microscopy. On the basis of these studies, the Fogarty silicone filled clamp appeared to be the least traumatic. However, further technical developments in this area are needed in order to obtain a completely atraumatic method of temporarily closing major blood vessels.

Animals↗
PubMed1978

Albuminated dacron protheses as improved blood vessel substitutes.

An improved vascular graft was achieved by treating knitted Dacron prostheses with cross-linked albumin. Eight segments, each six centimeters in length, were coated and implanted in the canine thoracic aorta for periods ranging from 24 hours to six months. The results were compared with the eight untreated grafts implanted for similar periods as control experiments. Albumin coating resulted in a faster healing : cells appeared earlier and collagen development was greater. The most beneficial effect of that treatment was the reduction in embolization, as shown by the considerable decrease in kidney damage.

Animals↗
PubMed1977

Stored blood microfiltration. Evaluation of micro-aggregate filter composed of polyurethane foam and nylon wool.

Aggregates of amorphous material which develop during storage of banked blood have been implicated as a cause of pulmonary micro-embolism in man following massive transfusion. Such pulmonary micro-embolism may be a causal factor in the development of post traumatic pulmonary insufficiency. At present several microaggregate filters for use in massive transfusion are commercially available, and on of these is the Fenwal filter. It is composed of a screen filter which removes microclots of 250 microns and higher, a layer of polyurethane foam and a layer of nylon wool. The resistance of this device is very acceptable and the filter may be used for several blood units, but its efficiency seems less than that of Dacron wool filter.

Blood Platelets↗
PubMed1977

Dacron as arterial prosthetic material: nature, properties, brands, fate and perspectives.

Dacron graft prostheses are routinely implanted to overcome impairment of arterial flow to distal tissues. Many different fabric configurations have been developped and evaluated. Unfortunately, after implantation the flow surface of any graft persists as a fibrinous lining. No human specimen has a commonly ingrown extension of tissue exceeding some millimeters in length. Full wall healing and endothelialization of arterial prosthesis is a goal that must be pursued intensively because it seems that the goal is attainable.

Animals↗