arterial cannulation for ascending aortic banding in swine

Bandagem Aórtica Ascendente para Estudo da Insuficiência Cardíaca Induzida por Sobrecarga de Pressão

Heart failure (HF) is a life-threatening disease that affects millions of people worldwide, causing major social and economic impacts1. One of its significant etiologies is aortic valve disease or aortic stenosis (AS). Aortic stenosis is more prevalent in advanced age and ranks as the second most common valvular lesion in the United States. AS-related mortality has also increased in Europe, particularly in countries without access to recent interventional procedures2. Given the complexity of HF and the scarcity of therapeutic innovations, there is a pressing need for reliable animal models that can replicate the human condition and facilitate the testing of new interventions3. While rodent models outnumber large animal models, the latter offers several advantages due to their size and physiological similarities, allowing the testing of drug doses and medical devices intended for human use.
The aim of this method is to establish a reproducible model of ascending aortic banding (AAB) applicable to most large animal species used in biomedical research. In this study, the procedure is demonstrated in swine using a minimally invasive approach, adhering to the 3Rs principles (replacement, reduction, and refinement4). This approach ensures the creation of an accurate pressure gradient, resulting in high reproducibility (potentially reducing the number of required animals). Additionally, the small surgical incision (2-3 cm) minimizes surgical insult, improving animal well-being compared to more aggressive approaches like sternotomy and larger thoracotomies5 (refinement). Furthermore, providing a video demonstration of the method, along with detailed descriptions in the literature, could potentially reduce the need for animals used solely for training purposes (replacement), further decreasing animal usage. This model can be adapted for different swine strains/breeds with distinct growth rates and induces sustained pressure overload, leading to significant hypertrophy after 1 or 2 months of follow-up.
Current methods employ fixed stenosis6, disregarding animal size variability, or calculate gradient using fluid-filled pressure readings7, which are less reliable than high-fidelity pressure sensors and are susceptible to signal damping8. Another approach uses a single pressure measurement distal to the stenosis5. However, calibrating the stenosis through simultaneous proximal and distal pressure signals using percutaneously delivered high-fidelity pressure sensors represents a substantial optimization of the protocol, resulting in improved group homogeneity. By visually demonstrating this method, other researchers should be able to replicate it without significant obstacles, increasing the availability of this model while promoting the application of the 3Rs principles.

Autor em destaque: Desenvolvimento de um modelo minimamente invasivo de animais de grande porte para pesquisa cardiovascular confiável e reprodutível 

Modelo Minimamente Invasivo de Estenose Aórtica em Suínos

Watch this Scientific Journal Video about Arterial Cannulation for Ascending Aortic Banding in Swine at JoVE.com

Arterial Cannulation for Ascending Aortic Banding in Swine   

Canulação Arterial para Bandagem da Aorta Ascendente em Suínos 

Para começar, identifique o local da punção para canulação arterial em um porco anestesiado. Com o uso da sonda vascular, identifique a artéria femoral comum e confirme a posição do marcador ultrassonográfico e a profundidade correta. Antes de montar a bainha introdutora, lave o introdutor e o dilatador com soro fisiológico heparinizado.Sob orientação ultrassonográfica, insira uma agulha arterial ecogênica na artéria femoral. Uma vez que a luz arterial é alcançada e o sangue arterial pulsátil sai do cubo da agulha, avance um fio-guia com ponta em J para dentro da artéria. Enquanto mantém a pressão no local da punção, remova a agulha e avance o conjunto introdutor e dilatador para dentro da artéria.Em seguida, remova o dilatador e aspirar o sangue do orifício lateral do introdutor para confirmar o posicionamento correto do introdutor. Lave sequencialmente o introdutor com soro fisiológico estéril. Finalmente, conecte uma linha de pressão arterial ao orifício lateral do introdutor da artéria femoral para monitorar a pressão arterial.

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JoVE Journal

Medicine

Arterial Cannulation for Ascending Aortic Banding in Swine

114 visualizações. Para começar, identifique o local da punção para canulação arterial em um porco anestesiado. Com o uso da sonda vascular, identifique a artéria femoral comum e confirme a posição do marcador ultrassonográfico e a profundidade correta. Antes de montar a bainha introdutora, lave o introdutor e o dilatador com soro fisiológico heparinizado.Sob orientação ultrassonográfica, insira uma agulha arterial ecogênica na artéria femoral. Uma vez que a luz arterial é alcançada e o ...

Vídeo: Arterial Cannulation for Ascending Aortic Banding in Swine   

A Minimally Invasive Model of Aortic Stenosis in Swine

Large animal models of heart failure play an essential role in the development of new therapeutic interventions due to their size and physiological similarities to humans. Efforts have been dedicated to creating a model of pressure-overload induced heart failure, and ascending aortic banding while still supra-coronary and not a perfect mimic of aortic stenosis in humans, closely resembling the human condition.
The purpose of this study is to demonstrate a minimally invasive approach to induce left ventricular pressure overload by placing an aortic band, precisely calibrated with percutaneously introduced high-fidelity pressure sensors. This method represents a refinement of the surgical procedure (3Rs), resulting in homogenous trans-stenotic gradients and reduced intragroup variability. Additionally, it enables swift and uneventful animal recovery, leading to minimal mortality rates. Throughout the study, animals were followed for up to 2 months after surgery, employing transthoracic echocardiography and pressure-volume loop analysis. However, longer follow-up periods can be achieved if desired. This large animal model proves valuable for testing new drugs, particularly those targeting hypertrophy and the structural and functional alterations associated with left ventricular pressure overload.

This protocol describes a minimally invasive surgical procedure for ascending aortic banding in swine.

Large animal models of heart failure play an essential role in the development of new therapeutic interventions due to their size and physiological ...