TY - JOUR

T1 - A novel porcine model for right ventricular dilatation by external suture plication of the pulmonary valve leaflets--practical and reproducible

AU - Agger, Peter

AU - Hyldebrandt, Janus Adler

AU - Nielsen, Eva Amalie

AU - Hjortdal, Vibeke

AU - Smerup, Morten

PY - 2010/6

Y1 - 2010/6

N2 - The right ventricle (RV) tolerates acute pulmonary valvular regurgitation fairly well, however, in the long-term dilatation and failure often ensues. There is little known of the structural and functional myocardial alterations following this pathophysiology, and therefore animal models are sought. We aimed to develop an animal experimental model for RV dilatation emphasizing feasibility, reproducibility and human compatibility. Free pulmonary valve insufficiency and RV dilatation were created with a novel external suture plication technique in nine 5 kg piglets. Six matched animals served as controls. After 10 weeks cardiac dimensions and physiology were assessed with in vivo cardiovascular MRI and conductance technique. RV end-diastolic volume increased 31% in the intervention group (P=0.03). The regurgitation fraction was 37% in the intervention group compared to -2% in controls (P<0.001). Conductance measurements showed preserved RV contractile function, but significant left ventricular diastolic impairment. This study is the first to show that pulmonary valve regurgitation, RV dilatation and functional impairment can be achieved by external leaflet plication. Compared to known methods, the advantages of this model are: 1) no induction of stenosis over time, 2) no risk of stent migration, and 3) very simple and reproducible.

AB - The right ventricle (RV) tolerates acute pulmonary valvular regurgitation fairly well, however, in the long-term dilatation and failure often ensues. There is little known of the structural and functional myocardial alterations following this pathophysiology, and therefore animal models are sought. We aimed to develop an animal experimental model for RV dilatation emphasizing feasibility, reproducibility and human compatibility. Free pulmonary valve insufficiency and RV dilatation were created with a novel external suture plication technique in nine 5 kg piglets. Six matched animals served as controls. After 10 weeks cardiac dimensions and physiology were assessed with in vivo cardiovascular MRI and conductance technique. RV end-diastolic volume increased 31% in the intervention group (P=0.03). The regurgitation fraction was 37% in the intervention group compared to -2% in controls (P<0.001). Conductance measurements showed preserved RV contractile function, but significant left ventricular diastolic impairment. This study is the first to show that pulmonary valve regurgitation, RV dilatation and functional impairment can be achieved by external leaflet plication. Compared to known methods, the advantages of this model are: 1) no induction of stenosis over time, 2) no risk of stent migration, and 3) very simple and reproducible.

KW - Animals

KW - Animals, Newborn

KW - Cardiac Catheterization

KW - Disease Models, Animal

KW - Feasibility Studies

KW - Female

KW - Hemodynamics

KW - Hypertrophy, Right Ventricular/etiology

KW - Magnetic Resonance Imaging

KW - Myocardial Contraction

KW - Pulmonary Valve/surgery

KW - Pulmonary Valve Insufficiency/complications

KW - Reproducibility of Results

KW - Stroke Volume

KW - Suture Techniques

KW - Swine

KW - Ventricular Dysfunction, Right/etiology

KW - Ventricular Function, Left

KW - Ventricular Function, Right

U2 - 10.1510/icvts.2009.227264

DO - 10.1510/icvts.2009.227264

M3 - Journal article

C2 - 20197345

VL - 10

SP - 962

EP - 966

JO - Interactive Cardiovascular and Thoracic Surgery

JF - Interactive Cardiovascular and Thoracic Surgery

SN - 1569-9293

IS - 6

ER -