Feasibility of airway replacement using stented aortic matrices: Bench to TRITON-01 study

Patients with long-segment tracheal defects, deemed technically inoperable, constitute a population in critical need of airway replacement. Regardless of the underlying cause—be it benign or malignant processes—this patient category requires either a tracheal transplant or admission to a palliative care facility. Despite over 50 years of exploration in thoracic surgery and regenerative medicine, airway transplantation remains a significant challenge. Various tracheobronchial substitutes, such as synthetic prostheses, bioprostheses, allografts, autografts, and bioengineered conduits, have been experimentally tested, yet none have provided a standardized method for airway replacement. Aortic grafts were suggested by Aortic grafts have been suggested as a biological matrix for extensive airway reconstruction as a biological matrix for extensive airway reconstruction. Cryopreserved aortic allografts, because of their availability in tissue banks and the lack of need for immunosuppressive therapy, were first used in clinical applications. The TRITON-01 study (NCT04263129) focuses on patients who received airway replacement to determine the routine applicability of this novel approach. The primary objective of this review is to provide information on advancements in the use of aortic allografts as tracheal replacements.