We thank Stilla Frede and Susanne Schulz for their technical assistance. This study received no funding.

This protocol was approved by the Ethics Committee for Animal Experimentation LANUV Recklinghausen (#84-02.04.2016.A374). Generally, this procedure is performed on adult mice &#62;10 weeks of age. However, it is possible to perform this surgery on younger animals as well. Surgical tools must be sterilized before use and all steps are to be performed under aseptic conditions.
1. Induction of Anesthesia and Intubation
<ol>
	<li>Inject buprenorphine 0.1 &#181;g/g body weight intraperitoneally for pain relief. Repeat the intraperitoneal injections of 0.1 mg/kg buprenorphine every 8 h for the next three days after surgery.</li>
	<li>For induction, place the mouse into an anesthesia induction box which is connected to the vaporizer set to 3.0 Vol% of isoflurane with an oxygen flow of 1 L/min.</li>
	<li>Ensure deep narcosis by inducing a tactile stimulus. 
	NOTE: Increase Vol% of isoflurane up to 5%, if anesthesia induction fails or narcosis is not deep enough.</li>
	<li>Pinch the tail of the mouse to ensure reflex absence. In case of complete absence of reflexes, weigh the mouse for optimal ventilator setup (see 1.12).</li>
	<li>Move the mouse to a temperature-controlled operating table to maintain a body temperature of 37 &#176;C throughout the procedure.</li>
	<li>Place the nose of the mouse in a plastic cone which is connected to the anesthesia induction box to maintain narcosis.</li>
	<li>Fix the upper incisors of the mouse with a nylon suture. Fixate the extremities with an adhesive tape.</li>
	<li>Apply pressure on the hind paw with the tip of the forceps to ensure an adequate narcosis again. In the absence of a withdrawal reflex proceed with the following steps. 
	NOTE: Increase volume % of isoflurane if anesthesia induction fails or narcosis is not deep enough and wait for the absence of the withdrawal reflex.</li>
	<li>Place sterile ophthalmic lubricant on the corneas to prevent desiccation under anesthesia.&#160;</li>
	<li>Lubricate the rectal probe to avoid rectal trauma. Insert a rectal temperature probe to ensure a core temperature of 37 &#176;C.</li>
	<li>Depilate the throat and the upper chest with depilatory cream according to the manufacturer&#39;s instructions. Wipe off the cream after 1 min. If necessary, repeat this step until successful. 
	NOTE: Use cotton-tipped swabs&#160;in case of bleeding.</li>
	<li>Clean the depilated area with 70% ethanol. Then apply povidone-iodine for local skin disinfection 3 times and for at least 3 min.</li>
	<li>Adjust ventilator settings to physiological parameters. Set the respiratory rate to 150/min and tidal volumes to 8-10 &#181;L/g body weight (BW).</li>
	<li>Put on a new pair of sterile gloves. Place the mouse under a surgical microscope and place a sterile fenestrated drape over the mouse.</li>
	<li>Incise the skin at the midline about 3 mm under the mandibular down to the 2nd rib. Identify midline and connective tissues of the submandibular gland. Then use angled intracapsular forceps to gently divide the gland at the midline bluntly with two forceps and explore the tracheal muscle.</li>
	<li>Prepare the trachea gently by pulling the para-tracheal muscles apart bluntly with intracapsular forceps.</li>
	<li>Pull on the tongue with forceps to straighten the throat for easier intubation conditions and gently insert an intubation cannula (OD 1.2 mm) inside the trachea. Confirm the intubation by direct visualization of the tube inside the trachea and by checking for proper chest movement.</li>
	<li>Adjust the isoflurane concentration after intubation to 2% isoflurane with a flow of 1.0 L/min and 100% O2. 
	NOTE: If breathing movements do not stop or mice start moving, first increase the respiratory rate up to 180/min. If necessary, increase the isoflurane concentration up to 3.5% secondarily until the mouse stops breathing on its own. Evaluate leakages or inadequate filling of the vaporizer as the most common problems.</li>
	<li>Alternatively, perform intubation as suggested in the following sub steps.
	<ol>
		<li>Position the mouse on a table at a 60&#176; angle.</li>
		<li>Fixate the extremities of the mouse with adhesive tape and recline the head.</li>
		<li>Place a cold-light source directly on the skin above the larynx.</li>
		<li>Pull the tongue gently with forceps to visualize the vocal chords.</li>
		<li>Insert a plastic tube of an IV-cannula (24 G) through the vocal chords and connect the plastic tube to the ventilator settings.</li>
		<li>Connect the ventilator to the cannula to confirm intubation by synchrone chest movements. 
		NOTE: If breathing movements do not stop or mice start moving, first increase the respiratory rate up to 180 per min. If necessary, increase secondarily the isoflurane concentration up to 3.5% until the mouse stops breathing on its own. Evaluate leakages or inadequate filling of the vaporizer as the most likely problems.</li>
	</ol>
	</li>
</ol>
2. Preoperative Doppler Measurement
<ol>
	<li>Prepare both carotid arteries which lay adjunct to the trachea by gently pulling the connective tissue apart with forceps.</li>
	<li>Place the tip of the 20 MHz Doppler probe with some sterile&#160;ultrasound gel on the right and the left carotid artery at an angle less than 45&#176;.</li>
	<li>Slowly rotate the probe to move it lateral and medial to find a Doppler signal and tilt the probe to optimize the signal.</li>
	<li>Use a Doppler software to display and store flow velocities in the right and left common carotid arteries on a computer.</li>
</ol>
3. Thoracotomy
<ol>
	<li>Use a set of sterile gloves for each individual mouse to prevent surgical site infections.</li>
	<li>Expand the skin incision down to the 2nd intercostal space with a scissor.</li>
	<li>Identify the 2nd intercostal space visually by counting the ribs and then bluntly penetrate this space with intracapsular forceps. 
	NOTE: The 1st rib is located under the clavicle and is therefore not visible because the 2nd intercostal space is found between first visible rib (i.e. 2nd rib) and the 3rd rib.</li>
	<li>Open the 2nd intercostal space with the help of forceps tips and insert the retractors.</li>
	<li>Adjust the retractors with a rubber band attached to the operating table to have a clear view of the thymus.</li>
	<li>In case of bleeding use a cotton-tip and press on the superficial vessels for 2 min.</li>
</ol>
4. Banding of the Transverse Aorta
<ol>
	<li>Adjust the magnification to 200% to identify midline and connective tissues. Then use angled forceps to gently divide the thymus. Remove fatty tissue until the aortic arch can be seen clearly.</li>
	<li>Prepare a tunnel with angled tying forceps under the transverse aorta between the brachiocephalic artery and left common carotid artery (see Figure 1). Hold the end of a 6.0 suture with the help of fine forceps and pass the thread under the aortic arch.</li>
	<li>Take the thread with the second forceps from the other side of the arch.</li>
	<li>Cut off a 3-mm long piece length of a 27 G to use the needle as a the spacer for TAC-ligation for mice weighing between 19 - 25 g body weight and a 26 G needle as a spacer for mice &#62;25 g BW.</li>
	<li>Carefully place the spacer parallel to the transverse aorta.</li>
	<li>Prepare a loose double knot on the spacer and ensure optimal placement of the spacer in parallel to the aorta. Then tie the first throw and quickly perform a second contrary throw. Remove the spacer promptly.</li>
	<li>To perform sham mice for control, follow the same protocol omitting the ligation of the aorta.</li>
	<li>Close the 2nd intercostal space with a 6.0 polypropylene suture. Pay special attention to the subclavian vessels when ligating.</li>
	<li>Suture&#160;the skin using a 6.0 polypropylene suture in a continuous suture pattern.</li>
</ol>
5. Confirmation of Successful Ligation of the Transverse Aorta
<ol>
	<li>Place a 20 MHz Doppler probe on both sides of the neck at a 45&#176; angle as in section 2.</li>
	<li>Document the flow velocities on each side. 
	NOTE: A successful TAC can be validated by Doppler flow velocity as shown in Figure 2. A flow velocity ratio of 4 - 10 between the right and left carotid artery usually guarantees adequate TAC (see Figure 2).</li>
</ol>
6. Heart harvest
<ol>
	<li>Induce narcosis according to steps 1.2. and 1.3.</li>
	<li>Place the mouse in an euthanasia chamber and adjust the carbon dioxide flow rate to displace 10 - 30% of the volume/minute.</li>
	<li>Fixate the mouse on a surgery table. Open the abdomen with scissors and harvest blood from the inferior vena cava with a cannula for further analysis.</li>
	<li>Cut the diaphragm and the sternal bone with strong scissors and remove the heart.</li>
	<li>Remove all arterial and connective tissue before weighing the heart.</li>
	<li>Separate the right ventricle and the septum from the left ventricle and weigh both samples.</li>
	<li>Freeze both tissue samples in liquid nitrogen.</li>
</ol>

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	<li>Tarnavski, O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mouse+surgical+models+in+cardiovascular+research.">Mouse surgical models in cardiovascular research.</a> Methods Mol Biol Clifton NJ. 573, 115-137 (2009).</li><li>Tarnavski, O., McMullen, J. R., Schinke, M., Nie, Q., Kong, S., Izumo, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mouse+cardiac+surgery:+comprehensive+techniques+for+the+generation+of+mouse+models+of+human+diseases+and+their+application+for+genomic+studies.">Mouse cardiac surgery: comprehensive techniques for the generation of mouse models of human diseases and their application for genomic studies.</a> Physiol Genomics. 16 (3), 349-360 (2004).</li><li>Rockman, H. A., 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=Segregation+of+atrial-specific+and+inducible+expression+of+an+atrial+natriuretic+factor+transgene+in+an+in+vivo+murine+model+of+cardiac+hypertrophy.">Segregation of atrial-specific and inducible expression of an atrial natriuretic factor transgene in an in vivo murine model of cardiac hypertrophy.</a> Proc Natl Acad Sci U S A. 88 (18), 8277-8281 (1991).</li><li>deAlmeida, A. C., van Oort, R. J., Wehrens, X. H. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transverse+Aortic+Constriction+in+Mice.">Transverse Aortic Constriction in Mice.</a> J Vis Exp JoVE. (38), (2010).</li><li>Grossman, W., Jones, D., McLaurin, L. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Wall+stress+and+patterns+of+hypertrophy+in+the+human+left+ventricle.">Wall stress and patterns of hypertrophy in the human left ventricle.</a> J Clin Invest. 56 (1), 56-64 (1975).</li><li>Hartley, C. J., Reddy, A. K., Madala, S., Michael, L. H., Entman, M. L., Taffet, 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=Doppler+estimation+of+reduced+coronary+flow+reserve+in+mice+with+pressure+overload+cardiac+hypertrophy.">Doppler estimation of reduced coronary flow reserve in mice with pressure overload cardiac hypertrophy.</a> Ultrasound Med Biol. 34 (6), 892-901 (2008).</li><li>Reddy, A. K., 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=Pulsed+Doppler+signal+processing+for+use+in+mice:+applications.">Pulsed Doppler signal processing for use in mice: applications.</a> IEEE Trans Biomed Eng. 52 (10), 1771-1783 (2005).</li><li>Shioura, K. M., Geenen, D. L., Goldspink, P. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+cardiac+function+with+the+pressure-volume+conductance+system+following+myocardial+infarction+in+mice.">Assessment of cardiac function with the pressure-volume conductance system following myocardial infarction in mice.</a> Am J Physiol - Heart Circ Physiol. 293 (5), H2870-H2877 (2007).</li><li>Zhang, B., Davis, J. P., Ziolo, M. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiac+Catheterization+in+Mice+to+Measure+the+Pressure+Volume+Relationship:+Investigating+the+Bowditch+Effect.">Cardiac Catheterization in Mice to Measure the Pressure Volume Relationship: Investigating the Bowditch Effect.</a> JoVE J Vis Exp. (100), e52618 (2015).</li><li>Barrick, C. J., Rojas, M., Schoonhoven, R., Smyth, S. S., Threadgill, D. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiac+response+to+pressure+overload+in+129S1/SvImJ+and+C57BL/6J+mice:+temporal-+and+background-dependent+development+of+concentric+left+ventricular+hypertrophy.">Cardiac response to pressure overload in 129S1/SvImJ and C57BL/6J mice: temporal- and background-dependent development of concentric left ventricular hypertrophy.</a> Am J Physiol Heart Circ Physiol. 292 (5), H2119-H2130 (2007).</li><li>Patten, R. D., Hall-Porter, M. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Small+animal+models+of+heart+failure:+development+of+novel+therapies,+past+and+present.">Small animal models of heart failure: development of novel therapies, past and present.</a> Circ Heart Fail. 2 (2), 138-144 (2009).</li><li>Zaw, A. M., Williams, C. M., Law, H. K. W., Chow, B. K. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Minimally+Invasive+Transverse+Aortic+Constriction+in+Mice.">Minimally Invasive Transverse Aortic Constriction in Mice.</a> J Vis Exp JoVE. (121), (2017).</li><li>Tavakoli, R., Nemska, S., Jamshidi, P., Gassmann, M., Frossard, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Technique+of+Minimally+Invasive+Transverse+Aortic+Constriction+in+Mice+for+Induction+of+Left+Ventricular+Hypertrophy.">Technique of Minimally Invasive Transverse Aortic Constriction in Mice for Induction of Left Ventricular Hypertrophy.</a> J Vis Exp. (127), (2017).</li><li>Kim, S. -. C., Boehm, O., Meyer, R., Hoeft, A., Kn&#252;fermann, P., Baumgarten, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Murine+Closed-chest+Model+of+Myocardial+Ischemia+and+Reperfusion.">A Murine Closed-chest Model of Myocardial Ischemia and Reperfusion.</a> J Vis Exp JoVE. (65), (2012).</li><li>Veldhuizen, R. A., Slutsky, A. S., Joseph, M., McCaig, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+mechanical+ventilation+of+isolated+mouse+lungs+on+surfactant+and+inflammatory+cytokines.">Effects of mechanical ventilation of isolated mouse lungs on surfactant and inflammatory cytokines.</a> Eur Respir J. 17 (3), 488-494 (2001).</li></ol>

The authors have nothing to disclose.

The rapid onset of hypertension due to TAC differs from clinically relevant hypertrophy caused by aortic stenosis or hypertension. Nevertheless, the use of small animal models to induce heart failure has many advantages and is, therefore, chosen by many investigators11. This closed chest-model improves the already existing models of the surgical technique to induce transverse aortic constriction in mice4.
The most critical step is the passage und...

Mouse models are often used to mimic human diseases1. Transverse aortic constriction (TAC) is used to induce pressure overload and left ventricular hypertrophy2. The open-chest TAC model in mice was validated by Rockman et al.3 and the surgical procedure is described in detail by DeAlmeida et al.4. Banding of the transverse aorta is more favorable in comparison to abdominal aortic constriction because a larger portion of the circulation can compensate negative effects of this latter procedure2.
The banding of the transverse aorta leads to an increased arterial pressure in the ascending aorta and brachiocephalic artery but leaves sufficient perfusion of the organs via the distal vessels (i.e. the left common carotid artery, the left subclavian artery, and descending aorta). This leads to an increased cardiac afterload and an elevated cardiac wall stress. The wall stress subsequently decreases due to fiber thickening5. The chronic change in cardiac hemodynamics results in maladaptation and dilatation of the left ventricle. This way the TAC creates a reproducible model of cardiac hypertrophy eventually leading to heart failure.
The standard procedure for TAC as described by DeAlmeide et al.4 approaches the aortic arch via a partial upper thoracotomy via dissection of the ribs or the sternum and entering the mediastinum as well as the pleural cavity. This allows for a good view of the aortic arch and its side branches. Unfortunately, the dissected ribs cannot be reattached, which leaves them floating freely and thereby altering the breathing dynamics.
We, therefore, established a minimally invasive closed-chest approach to the aortic arch using a lateral surgical approach via the 2nd intercostal space. The greatest advantage of this model is the ability to perform TAC without even cutting through the ribs. The surgical trauma is limited to the incision of the skin and the dissection of the intercostal muscles. This procedure minimizes the trauma itself and helps to maintain adequate chest stability.
Here we describe a detailed step-by-step procedure to perform TAC surgery in mice without performing the total or the upper thoracotomy. High frequency Doppler was used to ensure the success of TAC as previously described 6,7.

<table><tbody><tr><td>Pressure-volume catheter</td><td>Millar Instruments, USA</td><td>SPR-839</td><td></td></tr><tr><td>Mouse ventilator</td><td>Harvard Apparatus GmbH, Germany</td><td>Minivent - TYPE 845</td><td></td></tr><tr><td>Mouse ventilator</td><td>Harvard Apparatus GmbH, Germany</td><td>Y-connection with intubation cannula OD 1.2mm 73-2844</td><td></td></tr><tr><td>Vaporizer</td><td>Dr&amp;auml;ger Medical AG&amp;amp;CO.KG, Germany</td><td>19.3 Isofluran-Vaporizer (a newer version is available under catalog number&amp;nbsp; D-877-2010)</td><td></td></tr><tr><td>Microscope&amp;nbsp;</td><td>Leica Microsystems, Germany</td><td>MZ 7.5</td><td></td></tr><tr><td>Light source&amp;nbsp;</td><td>Schott AG, Germany</td><td>KL 1500 LCD</td><td></td></tr><tr><td>6-0 Prolene</td><td>Ethicon, USA</td><td>Polypropylene suture BV-1 9.3 mm 3/8c</td><td>suture for surgery</td></tr><tr><td>Seraflex</td><td>Serag Wiessner, Germany</td><td>USP 5/0 schwarz;&amp;nbsp; IC108000&amp;nbsp;</td><td>suture for constriction</td></tr><tr><td>Homoeothermic Controlled Operating Tables</td><td>Harvard Apparatus GmbH, Germany</td><td>Typ 872/3 HT with tripod stand and homoeothermic controller Type 874; 73-4233</td><td></td></tr><tr><td>Flexible Rectal Probe</td><td>Harvard Apparatus GmbH, Germany</td><td>1.6 mm OD; 55-7021</td><td></td></tr><tr><td>Doppler Signal Visualisation Instrument</td><td>Indus Instruments, USA</td><td>Doppler Signal Processing Workstation (DSWP) with 20MHz Pulsed Doppler Module</td><td></td></tr><tr><td>Arruga Intracapsular Forceps</td><td>Altomed, UK</td><td>A5400</td><td></td></tr><tr><td>Doppler Probe</td><td>Indus Instruments, USA</td><td>20MHz Tubing-mounted Probe</td><td></td></tr><tr><td>Jaffe Lid Retractor</td><td>Altomed, UK</td><td>A3513</td><td></td></tr></tbody></table>

a closed-chest model to induce transverse aortic constriction in mice

Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to perform a partial thoracotomy to visualize the transverse aortic arch. However, the surgical trauma caused by the thoracotomy in open-chest models changes the respiratory physiology as the ribs are dissected and left unattached after chest closure. To prevent this, we established a minimally invasive, closed chest approach via lateral thoracotomy. Herein we approach the aortic arch via the 2nd intercostal space without entering the chest cavities, leaving the mouse with a less traumatic injury to recover from. We perform this operation using standard laboratory settings for open chest TAC procedures with equal survival rates. Apart from maintaining physiological breathing patterns due to the closed chest approach, the mice seem to benefit by showing rapid recovery, as the less invasive technique appears to facilitate a fast healing process and to reduce immune response after trauma.

A successful TAC guarantees the induction of pressure overload and left ventricular hypertrophy. An ad hoc validation of pressure overload can be achieved using Doppler flow velocity measurement as shown in Figure 2. While preoperative blood flow velocity is equal in both carotid arteries, TAC causes an augmented blood velocity in the right carotid artery due to elevated pressure in the left ventricle and aorta while causing post-stenotic attenuated blood flo...

Watch this Scientific Journal Video about A Closed-chest Model to Induce Transverse Aortic Constriction in Mice at JoVE.com

A Closed-chest Model to Induce Transverse Aortic Constriction in Mice

Here, we present a protocol of Transverse Aortic constriction (TAC) via a lateral thoracotomy. This technique is a minimally invasive, closed chest surgical procedure aiming to simulate pressure overload and heart failure in mice utilizing standard TAC laboratory settings.

Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to ...

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18.9K Views.  University Hospital Bonn. Hier presenteren we een protocol van Transverse aorta vernauwing (TAC) via een laterale Thoracotomie. Deze techniek is een minimaal invasieve, gesloten borst chirurgische ingreep gericht om overbelasting van de druk en hartfalen in muizen met behulp van TAC laboratorium standaardinstellingen te simuleren.

Video: A Closed-chest Model to Induce Transverse Aortic Constriction in Mice

The CYP2D6 Animal Model: How to Induce Autoimmune Hepatitis in Mice

Autoimmune hepatitis is a rare but life threatening autoimmune disease of the liver of unknown etiology1,2. In the past many attempts have been made to generate an animal model that reflects the characteristics of the human disease 3-5. However, in various models the induction of disease was rather complex and often hepatitis was only transient3-5. Therefore, we have developed a straightforward mouse model that uses the major human autoantigen in type 2 autoimmune hepatitis (AIH-2), namely hCYP2D6, as a trigger6. Type 1 liver-kidney microsomal antibodies (LKM-1) antibodies recognizing hCYP2D6 are the hallmark of AIH-27,8. Delivery of hCYP2D6 into wildtype FVB or C57BL/6 mice was by an Adenovirus construct (Ad-2D6) that ensures a direct delivery of the triggering antigen to the liver. Thus, the ensuing local inflammation generates a fertile field9 for the subsequent development of autoimmunity. A combination of intravenous and intraperitoneal injection of Ad-2D6 is the most effective route to induce a long-lasting autoimmune damage to the liver (section 1). Here we provide a detailed protocol on how autoimmune liver disease is induced in the CYP2D6 model and how the different aspects of liver damage can be assessed. First, the serum levels of markers indicating hepatocyte destruction, such as aminotransferases, as well as the titers of hCYP2D6 antibodies are determined by sampling blood retroorbitaly (section 2). Second, the hCYP2D6-specific T cell response is characterized by collecting lymphocytes from the spleen and the liver. In order to obtain pure liver lymphocytes, the livers are perfused by PBS via the portal vein (section 3), digested in collagen and purified over a Percoll gradient (section 4). The frequency of hCYP2D6-specific T cells is analyzed by stimulation with hCYP2D6 peptides and identification of IFN&gamma;-producing cells by flow cytometry (section 5). Third, cellular infiltration and fibrosis is determined by immunohistochemistry of liver sections (section 6). Such analysis regimen has to be conducted at several times after initiation of the disease in order to prove the chronic nature of the model. The magnitude of the immune response characterized by the frequency and activity of hCYP2D6-specific T and/or B cells and the degree of the liver damage and fibrosis have to be assessed for a subsequent evaluation of possible treatments to prevent, delay or abrogate the autodestructive process of the liver.

Infection of mice with an Adenovirus expressing the major human autoantigen cytochrome P450 2D6 (hCYP2D6) recognized by sera of patients suffering from type 2 autoimmune hepatitis results in a persistent form of autoimmune-mediated liver disease characterized by extensive hepatitis, fibrosis and generation of a CYP2D6-specific immune response.

Autoimmune hepatitis is a rare but life threatening autoimmune disease of the liver of unknown etiology1,2. In the past many attempts have been made to ...

A Murine Closed-chest Model of Myocardial Ischemia and Reperfusion

Surgical trauma by thoracotomy in open-chest models of coronary ligation induces an immune response which modifies different mechanisms involved in ischemia and reperfusion. Immune response includes cytokine expression and release or secretion of endogenous ligands of innate immune receptors. Activation of innate immunity can potentially modulate infarct size. We have modified an existing murine closed-chest model using hanging weights which could be useful for studying myocardial pre- and postconditioning and the role of innate immunity in myocardial ischemia and reperfusion. This model allows animals to recover from surgical trauma before onset of myocardial ischemia.
Volatile anesthetics have been intensely studied and their preconditioning effect for the ischemic heart is well known. However, this protective effect precludes its use in open chest models of coronary artery ligation. Thus, another advantage could be the use of the well controllable volatile anesthetics for instrumentation in a chronic closed-chest model, since their preconditioning effect lasts up to 72 hours. Chronic heart diseases with intermittent ischemia and multiple hit models are other possible applications of this model.
For the chronic closed-chest model, intubated and ventilated mice undergo a lateral blunt thoracotomy via the 4th intercostal space. Following identification of the left anterior descending a ligature is passed underneath the vessel and both suture ends are threaded through an occluder. Then, both suture ends are passed through the chest wall, knotted to form a loop and left in the subcutaneous tissue. After chest closure and recovery for 5 days, mice are anesthetized again, chest skin is reopened and hanging weights are hooked up to the loop under ECG control.
At the end of the ischemia/reperfusion protocol, hearts can be stained with TTC for infarct size assessment or undergo perfusion fixation to allow morphometric studies in addition to histology and immunohistochemistry.

Surgical trauma induces an inflammatory response. Cytokines and endogenous ligands are known to modulate myocardial infarct size following ischemia and reperfusion. We present a modified closed-chest model of murine ischemia and reperfusion using hanging weights to minimize effects of thoracotomy.

Surgical trauma by thoracotomy in open-chest models of coronary ligation induces an immune response which modifies different mechanisms involved in ...

Transverse Aortic Constriction in Mice

Transverse aortic constriction (TAC) in the mouse is a commonly used experimental model for pressure overload-induced cardiac hypertrophy and heart failure.1 TAC initially leads to compensated hypertrophy of the heart, which often is associated with a temporary enhancement of cardiac contractility. Over time, however, the response to the chronic hemodynamic overload becomes maladaptive, resulting in cardiac dilatation and heart failure.2 The murine TAC model was first validated by Rockman et al.1, and has since been extensively used as a valuable tool to mimic human cardiovascular diseases and elucidate fundamental signaling processes involved in the cardiac hypertrophic response and heart failure development. When compared to other experimental models of heart failure, such as complete occlusion of the left anterior descending (LAD) coronary artery, TAC provides a more reproducible model of cardiac hypertrophy and a more gradual time course in the development of heart failure. Here, we describe a step-by-step procedure to perform surgical TAC in mice. To determine the level of pressure overload produced by the aortic ligation, a high frequency Doppler probe is used to measure the ratio between blood flow velocities in the right and left carotid arteries.3, 4 With surgical survival rates of 80-90%, transverse aortic banding is an effective technique of inducing left ventricular hypertrophy and heart failure in mice.

Transverse aortic constriction (TAC) in the mouse is a commonly used experimental model to study mechanisms underlying cardiac hypertrophy and heart failure development. Here, we describe procedures to constrict the aorta to create a reproducible degree of cardiac hypertrophy in mice.

Transverse aortic constriction (TAC) in the mouse is a commonly used experimental model for pressure overload-induced cardiac hypertrophy and heart ...

Biology

Assessment of Cardiac Morphological and Functional Changes in Mouse Model of Transverse Aortic Constriction by Echocardiographic Imaging

Transverse aortic constriction (TAC) in mice has been used as a valuable model to study mechanisms of cardiac hypertrophy and heart failure1. A reliable noninvasive method is essential to assess real-time cardiac morphological and functional changes in animal models of heart disease. Transthoracic echocardiography represents an important tool for noninvasive assessment of cardiac structure and function2. Here we used a high-resolution ultrasound imaging system to monitor myocardial remodeling and heart failure progression over time in a mouse model of TAC. B-mode, M-mode, and Doppler imaging were used to precisely assess cardiac hypertrophy, ventricular dilatation, and functional deterioration in mice following TAC. Color and pulse wave (PW) Doppler imaging was used to noninvasively measure pressure gradient across the aortic constriction created by TAC and to assess transmitral blood flow in mice. Thus transthoracic echocardiographic imaging provides comprehensive noninvasive measurements of cardiac dimensions and function in mouse models of heart disease.

The goal of this protocol is to noninvasively assess cardiac structural and functional changes in a mouse model of heart disease created by transverse aortic constriction, using B- and M-mode echocardiography and color/pulse wave Doppler imaging.

Transverse aortic constriction (TAC) in mice has been used as a valuable model to study mechanisms of cardiac hypertrophy and heart failure1. A reliable ...

Minimally Invasive Transverse Aortic Constriction in Mice

Minimally invasive transverse aortic constriction (MTAC) is a more desirable method for the constriction of the transverse aorta in mice than standard open-chest transverse aortic constriction (TAC). Although transverse aortic constriction is a highly functional method for the induction of high pressure in the left ventricle, it is a more difficult and lengthy procedure due to its use of artificial ventilation with tracheal intubation. TAC is oftentimes also less survivable, as the newer method, MTAC, neither requires the cutting of the ribs and intercostal muscles nor tracheal intubation with a ventilation setup. In MTAC, as opposed to a thoracotomy to access to the chest cavity, the aortic arch is reached through a midline incision in the anterior neck. The thyroid is pulled back to reveal the sternal notch. The sternum is subsequently cut down to the second rib level, and the aortic arch is reached simply by separating the connective tissues and thymus. From there, a suture can be wrapped around the arch and tied with a spacer, and then the sternal cut and skin can be closed. MTAC is a much faster and less invasive way to induce left ventricular hypertension and enables the possibility for high-throughput studies. The success of the constriction can be verified using high-frequency trans-thoracic echocardiography, particularly color Doppler and pulsed-wave Doppler, to determine the flow velocities of the aortic arch and left and right carotid arteries, the dimension of the blood vessels, and the left ventricular function and morphology. A successful constriction will also trigger significant histopathological changes, such as cardiac muscle cell hypertrophy with interstitial and perivascular fibrosis. Here, the procedure of MTAC is described, demonstrating how the resulting flow changes in the carotid arteries can be examined with echocardiography, gross morphology, and histopathological changes in the heart.

Minimally invasive transverse aortic constriction (MTAC) conserves the essentials of regular transverse aortic constriction (TAC) while eliminating the use of a ventilator with tracheal intubation. It proves to be a highly desirable method for high-throughput studies on left ventricular overload, particularly in translational studies.

Minimally invasive transverse aortic constriction (MTAC) is a more desirable method for the constriction of the transverse aorta in mice than standard ...

Technique of Minimally Invasive Transverse Aortic Constriction in Mice for Induction of Left Ventricular Hypertrophy

Transverse aortic constriction (TAC) in mice is one of the most commonly used surgical techniques for experimental investigation of pressure overload-induced left ventricular hypertrophy (LVH) and its progression to heart failure. In the majority of the reported investigations, this procedure is performed with intubation and ventilation of the animal which renders it demanding and time-consuming and adds to the surgical burden to the animal. The aim of this protocol is to describe a simplified technique of minimally invasive TAC without intubation and ventilation of mice. Critical steps of the technique are emphasized in order to achieve low mortality and high efficiency in inducing LVH.
Male C57BL/6 mice (10-week-old, 25-30 g, n=60) were anesthetized with a single intraperitoneal injection of a mixture of ketamine and xylazine. In a spontaneously breathing animal following a 3-4 mm upper partial sternotomy, a segment of 6/0 silk suture threaded through the eye of a ligation aid was passed under the aortic arch and tied over a blunted 27-gauge needle. Sham-operated animals underwent the same surgical preparation but without aortic constriction. The efficacy of the procedure in inducing LVH is attested by a significant increase in the heart/body weight ratio. This ratio is obtained at days 3, 7, 14 and 28 after surgery (n = 6 - 10 in each group and each time point). Using our technique, LVH is observed in TAC compared to sham animals from day 7 through day 28. Operative and late (over 28 days) mortalities are both very low at 1.7%.
In conclusion, our cost-effective technique of minimally invasive TAC in mice carries very low operative and post-operative mortalities and is highly efficient in inducing LVH. It simplifies the operative procedure and reduces the strain put on the animal. It can be easily performed by following the critical steps described in this protocol.

The aim of this protocol is to describe step-by-step the technique of minimally invasive transverse aortic constriction (TAC) in mice. By elimination of intubation and ventilation which are mandatory for the commonly used standard procedure, minimally invasive TAC simplifies the operative procedure and reduces the strain put on the animal.

Transverse aortic constriction (TAC) in mice is one of the most commonly used surgical techniques for experimental investigation of pressure ...

Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents

To better understand the left ventricular (LV) reverse remodeling (RR), we describe a rodent model wherein, after aortic banding-induced LV remodeling, mice undergo RR upon removal of the aortic constriction. In this paper, we describe a step-by-step procedure to perform a minimally invasive surgical aortic debanding in mice. Echocardiography was subsequently used to assess the degree of cardiac hypertrophy and dysfunction during LV remodeling and RR and to determine the best timing for aortic debanding. At the end of the protocol, terminal hemodynamic evaluation of the cardiac function was conducted, and samples were collected for histological studies. We showed that debanding is associated with surgical survival rates of 70-80%. Moreover, two weeks after debanding, the significant reduction of ventricular afterload triggers the regression of ventricular hypertrophy (~20%) and fibrosis (~26%), recovery of diastolic dysfunction as assessed by the normalization of left ventricular filling and end-diastolic pressures (E/e&#39;&#160;and LVEDP). Aortic debanding is a useful experimental model to study LV RR in rodents. The extent of myocardial recovery is variable between subjects, therefore, mimicking the diversity of RR that occurs in the clinical context, such as aortic valve replacement. We conclude that the aortic banding/debanding model represents a valuable tool to unravel novel insights into the mechanisms of RR, namely the regression of cardiac hypertrophy and the recovery of diastolic dysfunction.

Here we describe a step-by-step protocol of surgical aorta debanding in the well-established mice model of aortic-constriction. This procedure not only allows studying the mechanisms underlying the left ventricular reverse remodeling and regression of hypertrophy but also to test novel therapeutic options that might accelerate myocardial recovery.

To better understand the left ventricular (LV) reverse remodeling (RR), we describe a rodent model wherein, after aortic banding-induced LV remodeling, ...

Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy

Based on twice transverse aortic constrictions (TACs) in mice, it is proved that myocardial hypertrophic preconditioning (MHP) could attenuate cardiomyocyte hypertrophy and slow down progression to heart failure. For novices, however, the MHP model is usually quite difficult to establish because of the technical obstacles in ventilator operation, opening the chest repeatedly, and bleeding caused by debanding. To facilitate this model, to increase the surgical success rate and to reduce the incidence of bleeding, we switched to absorbable sutures for the first TAC combing with a ventilator-free technique. Using a 2-week absorbable suture, we demonstrated that this procedure could cause significant myocardial hypertrophy in 2 weeks; and 4 weeks after surgery, myocardial hypertrophy was almost completely regressed to the baseline. Using this protocol, the operators could master the MHP model easily with a lower operation mortality.

This protocol presents an improved method to obtain transient myocardial hypertrophy with absorbable suture, simulating left ventricular hypertrophy decrease after removing pressure overload. It could be valuable for the studies on myocardial hypertrophic preconditioning.

Based on twice transverse aortic constrictions (TACs) in mice, it is proved that myocardial hypertrophic preconditioning (MHP) could attenuate ...

A Modified Technique for Transverse Aortic Constriction in Mice

Transverse aortic constriction (TAC) is a frequently used surgery in research regarding heart failure and cardiac hypertrophy based on the formation of pressure overload in mouse models. The main challenge of this procedure is to clearly visualize the transverse aortic arch and precisely band the target vessel. Classical approaches perform a partial thoracotomy to expose the transverse aortic arch. However, it is an open-chest model that causes a rather large surgical trauma and requires a ventilator during the surgery. To prevent unnecessary trauma and simplify the operating procedure, the aortic arch is approached via the proximal proportion of the sternum, reaching and binding the target vessel using a small self-made retractor that contains a snare. This procedure can be conducted without entering the pleura cavity and does not need a ventilator or microsurgical operation, which leaves the mice with physiological breathing patterns, simplifies the procedure, and significantly reduces operation time. Due to the less invasive approach and less operation time, mice can undergo fewer stress reactions and recover rapidly.

The present protocol describes a modified and simplified technique with a minimally invasive transverse aortic constriction (TAC) procedure using a self-made retractor. This procedure can be conducted without a ventilator or microscope and introduces pressure overload, eventually leading to cardiac hypertrophy or heart failure.

Transverse aortic constriction (TAC) is a frequently used surgery in research regarding heart failure and cardiac hypertrophy based on the formation of ...

Transverse Aortic Arch Banding in Mouse Model: A Minimally Invasive Technique in Mice for Induction of High Pressure in the Left Ventricle

Source: Zaw, A. M. et al. <a href="https://www.jove.com/video/55293" target="_blank">Minimally Invasive Transverse Aortic Constriction in Mice</a>. J. Vis. Exp. (2017)
In this video, we demonstrate an experimental protocol for minimally invasive transverse aortic constriction in mice to examine pressure overload-induced heart failure.

Source: Zaw, A. M. et al. Minimally Invasive Transverse Aortic Constriction in Mice. J. Vis. Exp. (2017)
In this video, we demonstrate an experimental ...

A Closed-chest Model to Induce Transverse Aortic Constriction in Mice

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