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Transauricular embolization of the rabbit coronary artery for experimental myocardial infarction: comparison of a minimally invasive closed-chest model with open-chest surgery.

Katsanos K, Mitsos S, Koletsis E, Bravou V, Karnabatidis D, Kolonitsiou F, Diamantopoulos A, Dougenis D, Siablis D - J Cardiothorac Surg (2012)

Bottom Line: Electrocardiography (ECG), cardiac enzymes and transcatheter left ventricular end-diastolic pressure (LVEDP) measurements were recorded.Surviving animals were euthanized after 4 weeks and the hearts were harvested for Hematoxylin-eosin and Masson-trichrome staining.Increase of troponin and other cardiac enzymes, abnormal ischemic Q waves and LVEDP changes were recorded in both groups without any significant differences (p > 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Interventional Radiology, Patras University Hospital, School of Medicine, 26504, Rion, Greece. katsanos@med.upatras.gr

ABSTRACT

Introduction: To date, most animal studies of myocardial ischemia have used open-chest models with direct surgical coronary artery ligation. We aimed to develop a novel, percutaneous, minimally-invasive, closed-chest model of experimental myocardial infarction (EMI) in the New Zealand White rabbit and compare it with the standard open-chest surgical model in order to minimize local and systemic side-effects of major surgery.

Methods: New Zealand White rabbits were handled in conformity with the "Guide for the Care and Use of Laboratory Animals" and underwent EMI under intravenous anesthesia. Group A underwent EMI with an open-chest method involving surgical tracheostomy, a mini median sternotomy incision and left anterior descending (LAD) coronary artery ligation with a plain suture, whereas Group B underwent EMI with a closed-chest method involving fluoroscopy-guided percutaneous transauricular intra-arterial access, superselective LAD catheterization and distal coronary embolization with a micro-coil. Electrocardiography (ECG), cardiac enzymes and transcatheter left ventricular end-diastolic pressure (LVEDP) measurements were recorded. Surviving animals were euthanized after 4 weeks and the hearts were harvested for Hematoxylin-eosin and Masson-trichrome staining.

Results: In total, 38 subjects underwent EMI with a surgical (n = 17) or endovascular (n = 21) approach. ST-segment elevation (1.90 ± 0.71 mm) occurred sharply after surgical LAD ligation compared to progressive ST elevation (2.01 ± 0.84 mm;p = 0.68) within 15-20 min after LAD micro-coil embolization. Increase of troponin and other cardiac enzymes, abnormal ischemic Q waves and LVEDP changes were recorded in both groups without any significant differences (p > 0.05). Infarct area was similar in both models (0.86 ± 0.35 cm in the surgical group vs. 0.92 ± 0.54 cm in the percutaneous group;p = 0.68).

Conclusion: The proposed model of transauricular coronary coil embolization avoids thoracotomy and major surgery and may be an equally reliable and reproducible platform for the experimental study of myocardial ischemia.

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Open chest surgical ligation EMI model. Note the plain nylon suture knot (black arrow) placed around the distal LAD after heart exposure with a surgical mini median sternotomy incision.
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Figure 1: Open chest surgical ligation EMI model. Note the plain nylon suture knot (black arrow) placed around the distal LAD after heart exposure with a surgical mini median sternotomy incision.

Mentions: A skin incision was made over the subxiphoid region and sternum after a povidone-iodine antiseptic scrub. The xiphoid process was carefully detached from the sternal part of diaphragm. A mini median stermotomy was performed carefully along the midline to avoid injury to the parietal pleura. The sternal edges were spread and an incision was made at the pericardiac sac to expose the left myocardial ventricular wall. An 18-gauge catheter was inserted into the left ventricle via the left ventricular apex for continuous measurement of hemodynamics. Immediately before coronary artery ligation, 1 mg/kg of lidocaine was administered intravenously to minimize potentially lethal ventricular arrhythmias. A 5-0 monofilament polyprolene suture was placed around the left anterior descending (LAD) coronary artery approximately 8-10 mm from its origin (Figure 1). The sternum, muscle layers and skin were then closed and rabbits were allowed to recover.


Transauricular embolization of the rabbit coronary artery for experimental myocardial infarction: comparison of a minimally invasive closed-chest model with open-chest surgery.

Katsanos K, Mitsos S, Koletsis E, Bravou V, Karnabatidis D, Kolonitsiou F, Diamantopoulos A, Dougenis D, Siablis D - J Cardiothorac Surg (2012)

Open chest surgical ligation EMI model. Note the plain nylon suture knot (black arrow) placed around the distal LAD after heart exposure with a surgical mini median sternotomy incision.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3307024&req=5

Figure 1: Open chest surgical ligation EMI model. Note the plain nylon suture knot (black arrow) placed around the distal LAD after heart exposure with a surgical mini median sternotomy incision.
Mentions: A skin incision was made over the subxiphoid region and sternum after a povidone-iodine antiseptic scrub. The xiphoid process was carefully detached from the sternal part of diaphragm. A mini median stermotomy was performed carefully along the midline to avoid injury to the parietal pleura. The sternal edges were spread and an incision was made at the pericardiac sac to expose the left myocardial ventricular wall. An 18-gauge catheter was inserted into the left ventricle via the left ventricular apex for continuous measurement of hemodynamics. Immediately before coronary artery ligation, 1 mg/kg of lidocaine was administered intravenously to minimize potentially lethal ventricular arrhythmias. A 5-0 monofilament polyprolene suture was placed around the left anterior descending (LAD) coronary artery approximately 8-10 mm from its origin (Figure 1). The sternum, muscle layers and skin were then closed and rabbits were allowed to recover.

Bottom Line: Electrocardiography (ECG), cardiac enzymes and transcatheter left ventricular end-diastolic pressure (LVEDP) measurements were recorded.Surviving animals were euthanized after 4 weeks and the hearts were harvested for Hematoxylin-eosin and Masson-trichrome staining.Increase of troponin and other cardiac enzymes, abnormal ischemic Q waves and LVEDP changes were recorded in both groups without any significant differences (p > 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Interventional Radiology, Patras University Hospital, School of Medicine, 26504, Rion, Greece. katsanos@med.upatras.gr

ABSTRACT

Introduction: To date, most animal studies of myocardial ischemia have used open-chest models with direct surgical coronary artery ligation. We aimed to develop a novel, percutaneous, minimally-invasive, closed-chest model of experimental myocardial infarction (EMI) in the New Zealand White rabbit and compare it with the standard open-chest surgical model in order to minimize local and systemic side-effects of major surgery.

Methods: New Zealand White rabbits were handled in conformity with the "Guide for the Care and Use of Laboratory Animals" and underwent EMI under intravenous anesthesia. Group A underwent EMI with an open-chest method involving surgical tracheostomy, a mini median sternotomy incision and left anterior descending (LAD) coronary artery ligation with a plain suture, whereas Group B underwent EMI with a closed-chest method involving fluoroscopy-guided percutaneous transauricular intra-arterial access, superselective LAD catheterization and distal coronary embolization with a micro-coil. Electrocardiography (ECG), cardiac enzymes and transcatheter left ventricular end-diastolic pressure (LVEDP) measurements were recorded. Surviving animals were euthanized after 4 weeks and the hearts were harvested for Hematoxylin-eosin and Masson-trichrome staining.

Results: In total, 38 subjects underwent EMI with a surgical (n = 17) or endovascular (n = 21) approach. ST-segment elevation (1.90 ± 0.71 mm) occurred sharply after surgical LAD ligation compared to progressive ST elevation (2.01 ± 0.84 mm;p = 0.68) within 15-20 min after LAD micro-coil embolization. Increase of troponin and other cardiac enzymes, abnormal ischemic Q waves and LVEDP changes were recorded in both groups without any significant differences (p > 0.05). Infarct area was similar in both models (0.86 ± 0.35 cm in the surgical group vs. 0.92 ± 0.54 cm in the percutaneous group;p = 0.68).

Conclusion: The proposed model of transauricular coronary coil embolization avoids thoracotomy and major surgery and may be an equally reliable and reproducible platform for the experimental study of myocardial ischemia.

Show MeSH
Related in: MedlinePlus