מחקר שפורסם בפרסום זה נתמכה על ידי המכון הלאומי של דלקת מפרקים ושלד ושרירים ומחלות עור, חלק מן המכונים הלאומיים לבריאות, בפרס מספר R01-AR063084. התוכן הוא באחריות בלעדית של הכותבים ולא בהכרח מייצג את הדעות הרשמיות של המכון הלאומי לבריאות.

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ד&quot;ר נח Weisleder הוא מייסד ומדען ראשי בTRIM-edicine, Inc

מודלים איסכמיה reperfusion שריר הלב עכבר הם שיטה יעילה למחקר לב וכלי דם כדי לדמות מחלות לב אקוטיות או כרוניות קליניות 13,14. מאמץ משמעותי הוחל לפתח ולשכלל את גישות כירורגיות המייצרות אירועים איסכמיים ונזק reperfusion בלבם של מספר סוגים שונים של בעלי חיים. אמנם יש יתרונות מס?...

מודלים של בעלי החיים של אוטם שריר הלב (MI) הם חשובים במחקר של הפתופיזיולוגיה המורכבת של מחלת לב איסכמית 1. פגיעת איסכמיה reperfusion (I / R) היא תורם עיקרי לנזק בשריר הלב שנוצר במהלך MI. פציעת איסכמיה הראשונית המיוצרת על ידי חסימה של זרימת הדם הכליליים ניתן למזער בחולי MI על ידי השימוש באנגיופלסטיקה לשחזר זלוף מבעוד מועד. בעוד התערבות זו צמצמה באופן משמעותי את מספר מקרי המוות עקב אוטם לבבי חריף, שיקום של זרימת דם לתוצאות אזור איסכמי בפציעתי / R שמובילה למוות של שריר לב. זה אובדן של מסת שריר תורם לירידה בתפוקה והתקדמות לכיוון אי ספיקת לב לב. לכן, מחקר של המנגנונים שיגרמו למות cardiomyocyte מהפציעה I / R הוא קו חשוב של חקירה במחקר לב וכלי דם. קשירה כלילית כירורגי היא טכניקה שימושית ניסיונית כדי לגרום למודלים של MI בסוגים שונים של בעלי חיים, including חולדה, הכלב וחזיר. פרסומים במעבדות שונות הציגו שיטות שונות על הקמת מודל עכברי לב של פציעת I / R 2,3. על מנת לקבל תובנות לגבי מנגנונים אלה חייבים יש לנו גישה למודלים של בעלי חיים אמינים שיכול לשכפל כמה היבטים של הפתולוגיה MI. פיתוח של מודלים כאלה הוא גם חיוני לבדיקת גישות טיפוליות לטיפול באוטם לבבי ופגיעת I / R קשור. רוב הטכניקות הניתוחיות הזמינות כרגע כדי לדמות MI בחיות ניסוי כרוך בנתיחה כירורגית לתוך חלל בית החזה כדי לחשוף את העורק השמאלי קדמי יורד (LAD) שהאפיל לאחר מכן על ידי קשירה לתקופה מוגדרת בזמן כדי להפיק את אירוע איסכמי. אז מייתר שניתן להסיר כדי לאפשר reperfusion של האזור ודור איסכמי פציעה I / R. מגבלה העיקרית אחת הגישות אלה שבעמדתה של הספרות העוסק בנער היא לא תמיד לשחזרו במדויק, אשריכול להוביל לשינוי בחומרת MI הנגרמת על ידי גישה זו. רוב הטכניקות הזמינות רק בדרך כלל תיארו את המיקום המשוער של LAD בקיר הקדמי של הלב. כהסתעפות וכיוון של LAD יכולים להשתנות בבעלי חיים בודדים המיקום לא תמיד קבוע ויכול להתבלבל בקלות 4,5, מה שמוביל לסיבוכים אפשריים במהלך ניתוח 6. ההשלכות של מיקום לא תקין של המייתר יכולות לרוץ מהשתנות בגודל של האוטם המושרה בחדר השמאלי להתפשרות על הספציפיות של המודל לחלוטין. כאן אנו מציגים שיטה שונה לקלט / קשירה קבועה בעכברים המאפשרת דיוק משופר של מיקום של המייתר על LAD R ושריר לב. על ידי יישום גישות ספציפיות לחתך הראשוני והנתיחה פנימית, כמו גם השימוש במניפולציות כדי להרים את אטריה כדי לאפשר הערכה טובה יותר של LAD והאתר שבו הוא עולה מאב העורקים. הקמתעמדה בLAD ומקורו מספקת את ההזדמנות כדי לקשור LAD באופנה לשחזור. מודל זה שלי / קשירה קבועה R ושריר לב מקטין את השונות בגודל אוטם לאחר ניתוח לא רק, זה גם יכול להפחית את השכיחות של דימום יתר בזמן הניתוח.

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a murine model of myocardial ischemia-reperfusion injury through ligation of the left anterior descending artery

אוטם חריף או כרוני שריר הלב (MI) הם אירועי לב וכלי דם וכתוצאה מכך תחלואה ותמותה גבוהות. הקמת המנגנונים פתולוגיים בעבודה במהלך MI ופיתוח גישות טיפוליות יעילות דורשת מתודולוגיה כדי לדמות reproducibly השכיחות הקלינית ומשקפים את שינויי pathophysiological קשורים לאמ&quot;ן. כאן, אנו מתארים שיטה כירורגית כדי לגרום לאוטם לבבי במודלים של עכברים שיכולים לשמש לאיסכמיה reperfusion לטווח קצר (I / R) פציעה, כמו גם קשירת קבע. היתרון העיקרי של שיטה זו הוא להקל על מיקום של העורק הקדמי יורד השמאלי (LAD), כדי לאפשר לקשירה מדויקת של עורק זה כדי לגרום לאיסכמיה בחדר השמאלי של לב העכבר. מיקום מדויק של המייתר על LAD מגדיל שחזור של גודל אוטם ובכך מפיק תוצאות אמינות יותר. דיוק רב יותר במיקום של המייתר ישפר את גישות כירורגיות סטנדרטיות כדי לדמות MI בעכברים, לאהוס צמצום מספר חיות ניסוי הכרחיות למחקרים רלוונטיים מבחינה סטטיסטית ושיפור ההבנה של מנגנוני הפקת תפקוד לב לאחר האוטם הלבבי שלנו. מודל עכבר זה של MI שימושי גם עבור הבדיקות קליני של טיפולי מיקוד נזק בשריר הלב לאחר אוטם לבבי.

בעקבות 24 שעות של reperfusion, ניתוח של גודל אוטם ואזור בסיכון (AAR), על ידי צבע כחול phthalo וכלוריד triphenyl tetrazolium (TTC), קשירת LAD יכולה להיות מאושרת על ידי התבוננות לבנה לדיסטלי רקמת שריר הלב לתפר כמו גם תפקוד לקוי של הקיר הקדמי. Reperfusion יכול להיות מאומת על ידי חזרתו של צבע אדום לרקמת שר...

Watch this Scientific Journal Video about A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery at JoVE.com

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

אנחנו מציגים את שיטה כירורגית כדי לגרום לאיסכמיה / reperfusion הניסיוני (I / R) פציעה כדי לדמות אוטם שריר הלב (MI) בעכברי מודל, המאפשר ליותר בהירות במיצוב של קשירה בעורק השמאלי הקדמי יורד (LAD) כדי להגדיל את שחזור ניסויים MI בעכברים.

דגם של שריר הלב איסכמיה reperfusion הפגיעה Murine באמצעות קשירת של העורק השמאלי קדמי יורד

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

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JoVE Journal

Medicine

38.9K Views.  The Ohio State University.  אנחנו מציגים את שיטה כירורגית כדי לגרום לאיסכמיה / reperfusion הניסיוני (I / R) פציעה כדי לדמות אוטם שריר הלב (MI) בעכברי מודל, המאפשר ליותר בהירות במיצוב של קשירה בעורק השמאלי הקדמי יורד (LAD) כדי להגדיל את שחזור ניסויים MI בעכברים. 

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

Permanent Ligation of the Left Anterior Descending Coronary Artery in Mice: A Model of Post-myocardial Infarction Remodelling and Heart Failure

Heart failure is a syndrome in which the heart fails to pump blood at a rate commensurate with cellular oxygen requirements at rest or during stress. It is characterized by fluid retention, shortness of breath, and fatigue, in particular on exertion. Heart failure is a growing public health problem, the leading cause of hospitalization, and a major cause of mortality. Ischemic heart disease is the main cause of heart failure.
Ventricular remodelling refers to changes in structure, size, and shape of the left ventricle. This architectural remodelling of the left ventricle is induced by injury (e.g., myocardial infarction), by pressure overload (e.g., systemic arterial hypertension or aortic stenosis), or by volume overload. Since ventricular remodelling affects wall stress, it has a profound impact on cardiac function and on the development of heart failure. A model of permanent ligation of the left anterior descending coronary artery in mice is used to investigate ventricular remodelling and cardiac function post-myocardial infarction. This model is fundamentally different in terms of objectives and pathophysiological relevance compared to the model of transient ligation of the left anterior descending coronary artery. In this latter model of ischemia/reperfusion injury, the initial extent of the infarct may be modulated by factors that affect myocardial salvage following reperfusion. In contrast, the infarct area at 24 hr after permanent ligation of the left anterior descending coronary artery is fixed. Cardiac function in this model will be affected by 1) the process of infarct expansion, infarct healing, and scar formation; and 2) the concomitant development of left ventricular dilatation, cardiac hypertrophy, and ventricular remodelling.
Besides the model of permanent ligation of the left anterior descending coronary artery, the technique of invasive hemodynamic measurements in mice is presented in detail.

Heart failure is the leading cause of hospitalization and a major cause of mortality. A model of permanent ligation of the left anterior descending coronary artery in mice is applied to investigate ventricular remodelling and cardiac dysfunction post-myocardial infarction. The technique of invasive hemodynamic measurements in mice is presented.

קשירת קבע של העורק השמאלי קדמי יורד כלילית בעכברים: דגם של Remodelling אוטם שריר לב ופוסט-אי ספיקת לב

Heart failure is a syndrome in which the heart fails to pump blood at a rate commensurate with cellular oxygen requirements at rest or during stress. It ...

Murine Model of Intestinal Ischemia-reperfusion Injury

Intestinal ischemia is a life-threatening condition associated with a broad range of clinical conditions including atherosclerosis, thrombosis, hypotension, necrotizing enterocolitis, bowel transplantation, trauma and chronic inflammation. Intestinal ischemia-reperfusion (IR) injury is a consequence of acute mesenteric ischemia, caused by inadequate blood flow through the mesenteric vessels, resulting in intestinal damage. Reperfusion following ischemia can further exacerbate damage of the intestine. The mechanisms of IR injury are complex and poorly understood. Therefore, experimental small animal models are critical for understanding the pathophysiology of IR injury and the development of novel therapies.
Here we describe a mouse model of acute intestinal IR injury that provides reproducible injury of the small intestine without mortality. This is achieved by inducing ischemia in the region of the distal ileum by temporally occluding the peripheral and terminal collateral branches of the superior mesenteric artery for 60 min using microvascular clips. Reperfusion for 1 hr, or 2 hr after injury results in reproducible injury of the intestine examined by histological analysis. Proper position of the microvascular clips is critical for the procedure. Therefore the video clip provides a detailed visual step-by-step description of this technique. This model of intestinal IR injury can be utilized to study the cellular and molecular mechanisms of injury and regeneration.

Here we describe the detailed procedure of intestinal ischemia-reperfusion in mice which results in reproducible injury without mortality to encourage the standardization of this technique across the field. This model of intestinal ischemia-reperfusion injury can be utilized to study the cellular and molecular mechanisms of injury and regeneration.

דגם Murine של פגיעת המעיים איסכמיה reperfusion

Intestinal ischemia is a life-threatening condition associated with a broad range of clinical conditions including atherosclerosis, thrombosis, ...

A Mouse Model of Retinal Ischemia-Reperfusion Injury Through Elevation of Intraocular Pressure

Retinal ischemia-reperfusion (I/R) is a pathophysiological process contributing to cellular damage in multiple ocular conditions, including glaucoma, diabetic retinopathy, and retinal vascular occlusions. Rodent models of I/R injury are providing significant insights into mechanisms and treatment strategies for human I/R injury, especially with regard to neurodegenerative damage in the retinal neurovascular unit. Presented here is a protocol for inducing retinal I/R injury in mice through elevation of intraocular pressure (IOP). In this protocol, the ocular anterior chamber is cannulated with a needle, through which flows the drip of an elevated saline reservoir. Using this drip to raise IOP above systolic arterial blood pressure, a practitioner temporarily halts inner retinal blood flow (ischemia). When circulation is reinstated (reperfusion) by removal of the cannula, severe cellular damage ensues, resulting ultimately in retinal neurodegeneration. Recent studies demonstrate inflammation, vascular permeability, and capillary degeneration as additional elements of this model. Compared to alternative retinal I/R methodologies, such as retinal arterial ligation, retinal I/R injury by elevated IOP offers advantages in its&#160;anatomical specificity, experimental tractability, and technical accessibility, presenting itself as a valuable tool for examining neuronal pathogenesis and therapy in the retinal neurovascular unit.

This article describes a procedure for inducing retinal ischemia-reperfusion injury by elevated intraocular pressure in mice. Retinal ischemia-reperfusion injury by elevated intraocular pressure serves to model human pathologies characterized by compromised oxygen and nutrient delivery in the retina, enabling researchers to examine potential cellular mechanisms and treatments for human diseases of the retinal neurovascular unit.

במודל עכבר של רשתית איסכמיה reperfusion נזק ע&quot;י העלאת רמת הלחץ התוך עיני

Retinal ischemia-reperfusion (I/R) is a pathophysiological process contributing to cellular damage in multiple ocular conditions, including glaucoma, ...

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.

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 שמאל Anterior יורד (LAD) קשירת עורקים הכליליים: דגם משופר או פשוט עבור אוטם שריר לב

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 ...

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Coronary artery disease is the leading cause of death worldwide. After an acute myocardial infarction, early and successful myocardial intervention via recanalization of the coronary artery is the most effective strategy for reducing the size of ischemic myocardium. The coronary microvasculature cannot be visualized and imaged&#160;in vivo, but there are several invasive and noninvasive techniques that can be used to assess parameters which depend directly on coronary microvascular function. The endothelial function after ischemia reperfusion can be assessed also at the level of the coronary circulation via the coronary flow reserve (CFR).&#160;In this study, peak velocity of left anterior descending (LAD) coronary arteries was measured in rats in vivo via Transthoracic Doppler Echocardiography during resting and stress challenge (induced by Dobutamine). A normal heart can increase its coronary blood flow up to four times above the resting values during stress induction. Following ischemia reperfusion, we found a significantly diminished CFR, which can be used as a marker of coronary microvascular dysfunction. CFR has opened a window on the importance of microvascular dysfunction and has been shown to predict cardiovascular risk independent of whether the severe obstructive disease is present.

Coronary flow reserve (CFR), is defined as the ratio of maximal coronary blood flow to the resting coronary blood flow. We present a protocol for evaluating CFR in rats via ultrasound, which offers the opportunity to predict cardiovascular risk factors in the absence of obstructive coronary disease.

הערכה של שמורת זרם כלילית לאחר איסכמיה אוטם שריר הלב Reperfusion בחולדות

Coronary artery disease is the leading cause of death worldwide. After an acute myocardial infarction, early and successful myocardial intervention via ...

Murine Myocardial Infarction Model using Permanent Ligation of Left Anterior Descending Coronary Artery

Myocardial infarction (MI) and acute coronary diseases are among the most prominent causes of death in population with western lifestyle. The murine models of MI with permanent ligation of left-anterior descending (LAD) coronary artery closely mimics MI in humans. Murine models benefit from the extensive genetic engineering available nowadays. Here we propose a reproducible murine surgical model of myocardial infarction by permanent LAD coronary ligation. Our technique comprises anesthesia with ketamine/xylazine that can be rapidly reversed by administration of an antagonist, intubation without tracheotomy for mechanical-assisted ventilation, ventilation with application of extrinsic positive end-expiratory pressure (PEEP) to avoid alveolar collapse, a thoracotomy method limiting to the minimum surgical lesions made to skeletal muscles, and lung inflation without thoracentesis. This method is sparsely invasive, reproducible and reduces post-surgery mortality and complications.

Herein we describe a surgical procedure showing how to achieve permanent ligation of the left-anterior descending coronary artery in mice. This model is of high relevance to investigate the pathophysiology of myocardial infarction and the concomitant biological processes.

מודל אוטם שריר הלב באמצעות הארכה קבועה של עורק שמאלי קדמי כלילי יורד

Myocardial infarction (MI) and acute coronary diseases are among the most prominent causes of death in population with western lifestyle. The murine ...

Delayed Intramyocardial Delivery of Stem Cells after Ischemia Reperfusion Injury in a Murine Model

There is significant interest in the use of stem cells (SCs) for the recovery of cardiac function in individuals with myocardial injuries. Most commonly, cardiac stem cell therapy is studied by delivering SCs concurrently with the induction of myocardial injury. However, this approach presents two significant limitations: the early hostile pro-inflammatory ischemic environment may affect the survival of transplanted SCs, and it does not represent the subacute infarction scenario where SCs will likely be used. Here we describe a two-part series of surgical procedures for the induction of ischemia-reperfusion injury and delivery of mesenchymal stem cells (MSCs). This method of stem cell administration may allow for the longer viability and retention around damaged tissue by circumventing the initial immune response. A model of ischemia reperfusion injury was induced in mice accompanied by the delivery of mesenchymal stem cells (3.0 x 105), stably expressing the reporter gene firefly luciferase under the constitutively expressed CMV promoter, intramyocardially 7 days later. The animals were imaged via ultrasound and bioluminescent imaging for confirmation of injury and injection of cells, respectively. Importantly, there was no added complication rate when performing this two-procedure approach for SC delivery. This method of stem cell administration, collectively with the utilization of state-of-the-art reporter genes, may allow for the in vivo study of viability and retention of transplanted SCs in a situation of chronic ischemia commonly seen clinically, while also circumventing the initial pro-inflammatory response. In summary, we established a protocol for the delayed delivery of stem cells into the myocardium, which can be used as a potential new approach in promoting regeneration of the damaged tissue.

Stems cells are continuously investigated as potential treatments for individuals with myocardial damage, however, their decreased viability and retention within injured tissue can impact their long-term efficacy. In this manuscript we describe an alternative method for stem cell delivery in a murine model of ischemia reperfusion injury.

אספקה תוך-תוך-קרדיאלית מושהית של תאי גזע לאחר פציעת איסכמיה רפרציה במודל מורין

There is significant interest in the use of stem cells (SCs) for the recovery of cardiac function in individuals with myocardial injuries. Most commonly, ...

A Rat Lung Transplantation Model of Warm Ischemia/Reperfusion Injury: Optimizations to Improve Outcomes

From our experience with rat lung transplantation, we have found several areas for improvement. Information in the existing literature regarding methods for choosing appropriate cuff sizes for the pulmonary vein (PV), pulmonary artery (PA), or bronchus (Br) are varied, thus making the determination of proper cuff size during rat lung transplantation an exercise of trial and error. By standardizing the cuffing technique to use the smallest effective cuff appropriate for the size of the vessel or bronchus, one can make the transplantation procedure safer, faster, and more successful. Since diameters of the PV, PA, and Br are related to the body weight of the rat, we present a strategy to choosing an appropriate size using a weight-based guide. Since lung volume is also related to body weight, we recommend that this relationship should also be considered when choosing the proper volume of air for donor lung inflation during warm ischemia as well as for the proper volume of PBS to be instilled during bronchoalveolar lavage (BAL) fluid collection. We also describe methods for 4th intercostal space dissection, wound closure, and sample collection from both the native and transplanted lobes.

Here, we present optimizations to a rat lung transplantation model that serve to improve outcomes. We provide a size guide for cuffs based on body weight, a measurement strategy to ascertain the 4th intercostal space, and methods of wound closure and BAL (bronchoalveolar lavage) fluid and tissue collection.

מודל השתלת ריאה של חולדה של איסכמיה חמה / פגיעה ברפרפוזיה: אופטימיזציות לשיפור התוצאות

From our experience with rat lung transplantation, we have found several areas for improvement. Information in the existing literature regarding methods ...

Induction of Myocardial Infarction and Myocardial Ischemia-Reperfusion Injury in Mice

Acute myocardial infarction is a common cardiovascular disease with high mortality. Myocardial reperfusion injury can counteract the beneficial effects of heart reflow and induce secondary myocardial injury. A simple and reproducible model of myocardial infarction and myocardial ischemia-reperfusion injury is a good tool for researchers. Here, a customizable method to create a myocardial infarction (MI) model and MIRI by precision ligation of the left anterior descending coronary artery (LAD) through micromanipulation is described. Accurate and reproducible ligature positioning of the LAD helps obtain consistent results for heart injury. ST-segment changes can help to identify model accuracy. The serum level of cardiac troponin T (cTnT) is used to assess the myocardial injury, cardiac ultrasound is employed to evaluate the myocardial systolic function, and Evans-Blue/triphenyl tetrazolium chloride staining is used to measure infarct size. In general, this protocol reduces procedure duration, ensures controllable infarct size, and improves mouse survival.

Here we describe a simple and reproducible method that can induce myocardial infarction or myocardial ischemia-reperfusion injury in mice by precision ligation of the left anterior descending coronary artery through micromanipulation.

השראת אוטם שריר הלב ופגיעה באיסכמיה של שריר הלב בעכברים

Acute myocardial infarction is a common cardiovascular disease with high mortality. Myocardial reperfusion injury can counteract the beneficial effects of ...

Left Coronary Artery Ligation: A Surgical Murine Model of Myocardial Infarction

Ischemic heart disease and subsequent myocardial infarction (MI) is one of the leading causes of mortality in the United States and around the world. In order to explore the pathophysiological changes after myocardial infarction and design future treatments, research models of MI are required. Permanent ligation of the left coronary artery (LCA) in mice is a popular model to investigate cardiac function and ventricular remodeling post MI. Here we describe a less invasive, reliable, and reproducible surgical murine MI model by permanent ligation of the LCA. Our surgical model comprises of an easily reversible general anesthesia, endotracheal intubation that does not require a tracheotomy, and a thoracotomy. Electrocardiography and troponin measurement should be performed to ensure MI. Echocardiography at day 28 after MI will discern heart function and heart failure parameters. The degree of cardiac fibrosis can be evaluated by Masson's trichrome staining and cardiac MRI. This MI model is useful for studying the pathophysiological and immunological alterations after MI.

Presented here is a surgical procedure for permanent ligation of the left coronary artery in mice. This model can be used to investigate the pathophysiology and associated inflammatory response after myocardial infarction.

קשירת עורקים כליליים שמאליים: מודל מורין כירורגי של אוטם שריר הלב

Ischemic heart disease and subsequent myocardial infarction (MI) is one of the leading causes of mortality in the United States and around the world. In ...