Name: murine left anterior descending (lad) coronary artery ligation: an improved and simplified model for myocardial infarction
Uploaded: 2017-04-02T15:00:00
Description: Watch this Scientific Journal Video about Murine Left Anterior Descending LAD Coronary Artery Ligation: An Improved and Simplified Model for Myocardial Infarction at JoVE.com

This model was developed with the support of the National Institute of General Medical Sciences (NIGMS)/the National Institute of Health (NIH) grant 1P20GM103652 (Project# 3) (to MRA) and the American Heart Association (AHA) Grant-in-Aid 14GRNT20460291 (to MRA); the Brazilian government grant CAPES (to KR and FR); and a Brown University LINK award (to IM). We also acknowledge the outstanding technical support from our veterinarians and animal facility staff.

This animal protocol has been reviewed and approved by the Institutional Animal Care and Use Committee (IACUC) at Rhode Island Hospital.
1. Anesthesia and Intubation
<ol>
	<li>Weigh the mouse to calculate the dosage of post-operative pain medication.</li>
	<li>Place the mouse in an induction chamber and deliver 4% isoflurane for 9 - 10 min, monitoring the animal throughout. Turn on a hot bead sterilizer so that the apparatus can preheat to approximately 250 &#176;C. Preheating will take 15 -...

<ol>
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E., Tetens-Woodring, J., Belicha-Villanueva, A., Wilding, G. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+and+Efficacy+of+Various+Combinations+of+Injectable+Anesthetics+in+BALB/c+Mice.">Safety and Efficacy of Various Combinations of Injectable Anesthetics in BALB/c Mice.</a> J Am Assoc Lab Anim Sci. 47 (1), 11-17 (2008).</li><li>Kolk, M. V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=LAD-Ligation:+A+Murine+Model+of+Myocardial+Infarction.">LAD-Ligation: A Murine Model of Myocardial Infarction.</a> J Vis Exp. (32), e1438 (2009).</li><li>Wu, Y., Yin, X., Wijaya, C., Huang, M. H., McConnell, B. 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With an increasing use of the MI model in laboratories, the described procedure seeks to increase the efficiency and survival rate of the mice while minimizing their post-operative pain and discomfort. This protocol strives to minimize mortality by making numerous improvements to various aspects of the LAD ligation procedure. There are a few distinctions. Some murine intubation studies that utilize ketamine and xylazine along with isoflurane for induction, due to the benefit of their longer duration of a...

Coronary disease, or ACS, is the most prevalent cardiovascular event and will be considered the main cause of morbidity and mortality worldwide in 20201. The cause of ACS is the presence of a myocardial thrombosis due to the rupture of a coronary atherosclerotic plaque that blocks or reduces blood flow to the heart tissue2. Therefore, there are clinical signs consistent with the presence of acute myocardial ischemia, such as myocardial infarction (MI)3,4. MI leads to a loss in mass of the cardiomyocytes and a progression to pathological ventricular remodeling, which can lead to ventricular dysfunction and heart failure5,6.
One of the most effective ways to study IHD has been to mimic human myocardial infarction in an animal model. This is achieved by occluding the LAD in mice. Using this model, we study how the heart can be protected from the damage resulting from IHD.
Over the last decade, researchers have shifted from using larger animal models to smaller animals, including the shift from rats to mice. The smaller mouse model is starting to be preferred for many reasons, including their small size, large litter size, low cost to maintain, and short gestation period, as well as for the expansive availability of transgenic and gene knockout models7. Although mice are small in size, new surgical instruments specifically designed for them have aided in this development. Our method utilizes these new surgical instruments.
While several methods implement an invasive tracheotomy, we use a less invasive method of endotracheal intubation. Using overhead illumination of the oropharynx, we intubate without creating any incisions, providing a safer and less traumatic experience for the animal. The mouse is then placed on a ventilator and kept on isoflurane during the entire procedure. Due to the short duration of anesthesia produced by the drug, it only takes a few minutes for the animal to recover from the anesthetic once it is discontinued. Our surgical model also includes a minimally invasive thoracentesis. The careful removal of blood and excess air from the chest cavity using thoracentesis through the original thoracotomy incision has addressed a common post-operative complication of the LAD ligation: the tension pneumothorax. This method, which eliminates the need for the two additional incisions used in other methods-one for the tracheotomy and another for the thoracentesis-has yielded fewer post-surgical complications and has drastically reduced mortality.

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murine left anterior descending (lad) coronary artery ligation: an improved and simplified model for myocardial infarction

Ischemic heart disease (IHD), or acute coronary syndrome (ACS), is one of the leading causes of death in the United States. IHD is characterized by reduced blood supply to the heart, resulting in the loss of oxygen to and the ensuing necrosis of the heart muscle. The MI model has gained popularity for its use as a short-term ischemia-reperfusion model and a long-term permanent ligation model. Below, we describe a reliable method for the permanent ligation of the LAD. With mouse genetic engineering technology becoming more advanced, and with an increasing availability of quality murine surgical instruments, the mouse has become a popular model for MI surgeries. Our surgical model incorporates the use of an easily reversible anesthetic for the rapid recovery of the mouse; a minimally invasive endotracheal intubation without involving a tracheotomy; and a thoracentesis through the original thoracotomy site without creating an additional incision in the chest, as is done in some other methods, to effectively remove excess blood and air from the chest cavity. This method is comparatively less invasive than other methods, which dramatically reduces surgical and post-surgical complications and mortality and improves reproducibility.

The mice are euthanized twenty-eight days after surgery, and the hearts are harvested and examined. The mice are anesthetized with 50 - 75 mg/kg ketamine and 5 - 10 mg/kg xylazine. When the animal is under adequate anesthesia, the thoracic cavity is opened, and using a 23-gauge needle, cold potassium chloride (KCL, 30 mM) is injected into the posterior basal region of the heart. The heart is arrested in diastole. For further validation of the ligation, the heart is removed from the animal...

Watch this Scientific Journal Video about Murine Left Anterior Descending LAD Coronary Artery Ligation: An Improved and Simplified Model for Myocardial Infarction at JoVE.com

Murine Left Anterior Descending LAD Coronary Artery Ligation: An Improved and Simplified Model for Myocardial Infarction

We provide a reliable method for left anterior descending artery (LAD) ligation in a mouse model. This method is comparatively less invasive than other methods, involving endotracheal intubation, a left-sided thoracotomy approach, and thoracentesis. This method can be used as a model for both acute and chronic myocardial infarction (MI).

Murine Left Anterior Descending (LAD) Coronary Artery Ligation: An Improved and Simplified Model for Myocardial Infarction

Ischemic heart disease (IHD), or acute coronary syndrome (ACS), is one of the leading causes of death in the United States. IHD is characterized by ...

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Mouse models are a valuable tool for studying acute injury and chronic remodeling of the myocardium in vivo.  With the advent of genetic modifications to ...

Modified Technique for Coronary Artery Ligation in Mice

Myocardial infarction (MI) is one of the most important causes of mortality in humans1-3. In order to improve morbidity and mortality in patients with MI ...

A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery

Acute or chronic myocardial infarction (MI) are cardiovascular events resulting in high morbidity and mortality. Establishing the pathological mechanisms ...

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Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ...

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