Name: surgical swine model of chronic cardiac ischemia treated by off-pump coronary artery bypass graft surgery
Uploaded: 2018-03-27T13:00:00
Description: Watch this Scientific Journal Video about Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery at JoVE.com

Questo lavoro è stato supportato da VA al merito recensione #I01 BX000760 (RFK) da Stati Uniti (US) Department of Veterans Affairs BLR e D. Il contenuto di questo lavoro non rappresentano le opinioni di l'US Department of Veterans Affairs del governo degli Stati Uniti.

Tutti gli studi sugli animali sono stati approvati dalle commissioni di utilizzo del Minneapolis VA Medical Center e l'Università del Minnesota e istituzionali Animal Care. Seguire le attuali linee guida per l'uso e la cura di animali da laboratorio National Institutes of Health.
1. sospensione chirurgia
<ol><li>Preparazione degli animali<ol>
<li>Per creare un modello del miocardio hibernating, utilizzare 5 - settimana-vecchio, donna, maiali Yorkshire, che pesano nella gamma di 8-10 kg con ...

<ol>
	<li>Mozaffarian, D., 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=Heart+Disease+and+Stroke+Statistics-2016+Update+A+Report+From+the+American+Heart+Association.">Heart Disease and Stroke Statistics-2016 Update A Report From the American Heart Association.</a> Circulation. 133 (4), 350 (2015).</li><li>Di Carli, M. F., 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=Value+of+metabolic+imaging+with+positron+emission+tomography+for+evaluating+prognosis+in+patients+with+coronary+artery+disease+and+left+ventricular+dysfunction.">Value of metabolic imaging with positron emission tomography for evaluating prognosis in patients with coronary artery disease and left ventricular dysfunction.</a> Am J Cardiol. 73 (8), 527-533 (1994).</li><li>Gerber, B. L., 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=Prognostic+value+of+myocardial+viability+by+delayed-enhanced+magnetic+resonance+in+patients+with+coronary+artery+disease+and+low+ejection+fraction:+impact+of+revascularization+therapy.">Prognostic value of myocardial viability by delayed-enhanced magnetic resonance in patients with coronary artery disease and low ejection fraction: impact of revascularization therapy.</a> J Am Coll Cardiol. 59 (9), 825-835 (2012).</li><li>McFalls, E., 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=Regional+glucose+uptake+within+hypoperfused+swine+myocardium+as+measured+by+positron+emission+tomography.">Regional glucose uptake within hypoperfused swine myocardium as measured by positron emission tomography.</a> Am J Physiol-Heart C. 272 (1), 343-349 (1997).</li><li>Velazquez, E. J., 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=Coronary-artery+bypass+surgery+in+patients+with+left+ventricular+dysfunction.">Coronary-artery bypass surgery in patients with left ventricular dysfunction.</a> New Engl J Med. 364 (17), 1607-1616 (2011).</li><li>Canty, J. M., Fallavollita, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hibernating+myocardium.">Hibernating myocardium.</a> J Nucl Cardiol. 12 (1), 104-119 (2005).</li><li>Joyce, D., 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=Revascularization+and+ventricular+restoration+in+patients+with+ischemic+heart+failure:+the+STICH+trial.">Revascularization and ventricular restoration in patients with ischemic heart failure: the STICH trial.</a> Curr Opin Cardiol. 18 (6), 454-457 (2003).</li><li>Shah, B. N., Khattar, R. S., Senior, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+hibernating+myocardium:+current+concepts,+diagnostic+dilemmas,+and+clinical+challenges+in+the+post-STICH+era.">The hibernating myocardium: current concepts, diagnostic dilemmas, and clinical challenges in the post-STICH era.</a> Eur Heart J. 34 (18), 1323-1336 (2013).</li><li>Stone, L. L. H., 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=Magnetic+resonance+imaging+assessment+of+cardiac+function+in+a+swine+model+of+hibernating+myocardium+3+months+following+bypass+surgery.">Magnetic resonance imaging assessment of cardiac function in a swine model of hibernating myocardium 3 months following bypass surgery.</a> J Thorac Cardiov Sur. , (2016).</li><li>Kukulski, T., 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=Implication+of+right+ventricular+dysfunction+on+long-term+outcome+in+patients+with+ischemic+cardiomyopathy+undergoing+coronary+artery+bypass+grafting+with+or+without+surgical+ventricular+reconstruction.">Implication of right ventricular dysfunction on long-term outcome in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting with or without surgical ventricular reconstruction.</a> J Thorac Cardiov Sur. 149 (5), 1312-1321 (2014).</li><li>Rahimtoola, S. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+hibernating+myocardium.">The hibernating myocardium.</a> Am Heart J. 117 (1), 211-221 (1989).</li><li>Fallavollita, J. A., Logue, M., Canty, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stability+of+hibernating+myocardium+in+pigs+with+a+chronic+left+anterior+descending+coronary+artery+stenosis:+absence+of+progressive+fibrosis+in+the+setting+of+stable+reductions+in+flow,+function+and+coronary+flow+reserve.">Stability of hibernating myocardium in pigs with a chronic left anterior descending coronary artery stenosis: absence of progressive fibrosis in the setting of stable reductions in flow, function and coronary flow reserve.</a> J Am Coll Cardiol. 37 (7), 1989-1995 (2001).</li><li>White, F. C., Carroll, S. M., Magnet, A., Bloor, C. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Coronary+collateral+development+in+swine+after+coronary+artery+occlusion.">Coronary collateral development in swine after coronary artery occlusion.</a> Circ Res. 71 (6), 1490-1500 (1992).</li><li>Viscardi, A. V., Hunniford, M., Lawlis, P., Leach, M., Turner, P. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+a+Piglet+Grimace+Scale+to+Evaluate+Piglet+Pain+Using+Facial+Expressions+Following+Castration+and+Tail+Docking:+A+Pilot+Study.">Development of a Piglet Grimace Scale to Evaluate Piglet Pain Using Facial Expressions Following Castration and Tail Docking: A Pilot Study.</a> Front Vet Sci. 4, 51 (2017).</li><li>Holley, C. T., Long, E. K., Lindsey, M. E., McFalls, E. O., Kelly, R. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recovery+of+hibernating+myocardium:+what+is+the+role+of+surgical+revascularization.">Recovery of hibernating myocardium: what is the role of surgical revascularization.</a> J Cardiac Surg. 30 (2), 224-231 (2015).</li><li>Cooper, H. A., Braunwald, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+importance+of+stunned+and+hibernating+myocardium.">Clinical importance of stunned and hibernating myocardium.</a> Coronary Artery Dis. 12 (5), 387-392 (2001).</li><li>McFalls, E. O., 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=Utility+of+positron+emission+tomography+in+predicting+improved+left+ventricular+ejection+fraction+after+coronary+artery+bypass+grafting+among+patients+with+ischemic+cardiomyopathy.">Utility of positron emission tomography in predicting improved left ventricular ejection fraction after coronary artery bypass grafting among patients with ischemic cardiomyopathy.</a> Cardiology. 93 (1-2), 105-112 (2000).</li><li>Pasquet, 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=Prediction+of+global+left+ventricular+function+after+bypass+surgery+in+patients+with+severe+left+ventricular+dysfunction.+Impact+of+pre-operative+myocardial+function,+perfusion,+and+metabolism.">Prediction of global left ventricular function after bypass surgery in patients with severe left ventricular dysfunction. Impact of pre-operative myocardial function, perfusion, and metabolism.</a> Eur Heart J. 21 (2), 125-136 (2000).</li></ol>

Qui, indichiamo che il nostro modello di suina di HM accuratamente imita l'esperienza clinica dei pazienti con la malattia del singolo vaso e funzione ventricolare sinistra conservata. Prima la rivascolarizzazione, Mostra degli animali con singolo vaso HM danno minimo nella funzione globale come misurata dalla frazione di espulsione, ma Visualizza significativa riduzione di ispessimento di parete regionali. Dopo la rivascolarizzazione, formazione immagine di CMR a uno o tre mesi di recupero dimostra conservata pervietà ...

Malattia coronarica (CHD) colpisce circa 15,5 milioni di persone in Stati Uniti d'America 1 ed è una delle principali cause di morte a livello globale. Mentre il tasso di mortalità connesso con CHD è sceso negli ultimi anni, l'incidenza e l'onere per i pazienti e il sistema sanitario rimangono alta 1. Trattamento primario di CAD severo è rivascolarizzazione, che migliora la sopravvivenza e riduce l'angina2,3,4. Tuttavia, la funzione cardiaca spesso rimane depressa, soprattutto sotto il carico di lavoro aumentato e può progredire a insufficienza cardiaca5,6. I test clinici di chirurgia di bypass coronarico (CABG) per ischemia cronica dimostrano miglioramento nella sopravvivenza e sintomi, ma espulsione frazione spettacoli solo modesti miglioramenti di 8-10% 7,8. Il nostro modello innovativo e ben caratterizzati suina di ischemia del miocardio cronica è un modello di clinica CAD con stenosi vascolare progressiva. Abbiamo dimostrato ridotta contrattilità del miocardio derivanti dalla progressiva riduzione di flusso di sangue 9. Il miocardio non non infarto e possa rimanere vitale in questo scenario. Recupero è possibile, anche se i risultati sono variabili anche con rivascolarizzazione tempestiva. Cronicamente miocardio ischemico che rimane vitale è stata caratterizzata da riduzione del flusso sanguigno e funzione a riposo con riserva contrattile mantenuto è stato chiamato HM e trattamento richiede CABG. Anche se la rivascolarizzazione dell'HM dovrebbe ristabilire la funzione contrattile, osservazioni cliniche e sperimentali dimostrano che il recupero è incompleto8,10.
HM è caratterizzata dalla presenza di vitali ancora miocardio disfunzionale in presenza di riduzione di flusso sanguigno regionale11. Nonostante alterata contrattilità e attività metabolica a riposo, HM è in grado di dimostrare la riserva funzionale e metabolica sotto stimolazione inotropa12. HM è ritenuto sospetto in una maggioranza dei pazienti con CAD e comprende un ampio spettro di malattia. In questo protocollo, dimostriamo il nostro modello di suina stabilito di HM aggirato con arteria mammaria interna di sinistra (LIMA) all'arteria LAD che simula lo scenario clinico. La suina fornisce un eccellente modello di malattia di cuore sopra altri grandi animali come non hanno collaterals passerella dell'epicardio. In questo modo la stenosi del ragazzo da solo per provocare l'ischemia regionale13.
Qui, descriviamo il metodo chirurgico dell'induzione del miocardio hibernating in maiali con la creazione del singolo-vaso stenosi all'arteria del ragazzo. Una volta stabilita l'ischemia cronica (8 settimane post impianto di constrictor LAD), descriviamo il metodo di ricreare il trattamento clinico per HM nel nostro modello suina: innesto di esclusione di un'arteria coronaria della fuori-pompa. Questi metodi chirurgici possono essere utilizzati per studiare non solo un modello clinicamente rilevante di ischemia cardiaca cronica, ma anche per studiare gli effetti della chirurgia del bypass su ischemia cardiaca così come prova di potenziali terapie alternative o adjunctive per ischemia cardiaca.

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	<colgroup>
		<col />
		<col />
		<col />
		<col />
	</colgroup>
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Bair Hugger</td>
			<td style="width:223px;">3M</td>
			<td style="width:203px;">Model 505</td>
			<td style="width:468px;">Patient Warming system</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">SR Buprenorphine 10 mg/mL</td>
			<td style="width:223px;">Abbott Labs</td>
			<td style="width:203px;">NADA 141-434</td>
			<td>Post operative Analgesic</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Surgical Spring Clip</td>
			<td>Applied Medical</td>
			<td>A1801</td>
			<td>Clamp end of LIMA after takedown</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Arterial Line Kit</td>
			<td>Arrow</td>
			<td>ASK-04510-HF</td>
			<td>Femoral catheter for blood pressure monitoring</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">1000mL 0.9% Sodium chloride</td>
			<td>Baxter</td>
			<td>2B1324X</td>
			<td>IV replacement fluid</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">250 mL 0.9% saline</td>
			<td>Baxter</td>
			<td>&#160;UE1322D</td>
			<td>Replacement IV Fluid&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">500mL 0.9% Sodium chloride</td>
			<td>Baxter</td>
			<td>2B1323Q</td>
			<td>Drug delivery, Provide mist for Blower Mister</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Flo-thru 1.0</td>
			<td>Baxter</td>
			<td>FT-12100</td>
			<td>used to anastomos LIMA to L</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Flo-thru 1.25</td>
			<td>Baxter</td>
			<td>FT-12125</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Flo-thru 1.5</td>
			<td>Baxter</td>
			<td>FT-12150</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Flo-thru 2.0</td>
			<td>Baxter</td>
			<td>FT-12200</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Cloroprep</td>
			<td style="width:223px;">Becton Dickenson</td>
			<td style="width:203px;">260815</td>
			<td>Surgical skin prep</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Meloxicam</td>
			<td>Boehringer Ingelheim Vetmedica, Inc.</td>
			<td>0010-6013-01</td>
			<td>NSAID for analgesia</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Hypafix</td>
			<td>BSN Medical</td>
			<td>4210</td>
			<td>Secure wound dressing and IV catheters</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">IV Tubing for Blower Mister</td>
			<td>Carefusion</td>
			<td>42493E</td>
			<td>Adapts to IV Fluids for Blower/Mister</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Bovie Cautery hand piece&#160;</td>
			<td>Covidien</td>
			<td>E2516</td>
			<td>Hemostasis&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Chest Tube</td>
			<td>Covidien</td>
			<td>8888561043</td>
			<td>Evacuates air from chest cavity&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Monopolar Cautery&#160;</td>
			<td>Covidien</td>
			<td>Valleylab FT10</td>
			<td>Hemostasis&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Telpha pad</td>
			<td style="width:223px;">Covidien</td>
			<td style="width:203px;">2132</td>
			<td>Sterile wound dressing</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">4-0 Tevdek II Strands</td>
			<td style="width:223px;">Deknatel</td>
			<td style="width:203px;">7-922</td>
			<td>Suture to secure constrictor around LAD</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Propofol</td>
			<td style="width:223px;">Diprivan</td>
			<td style="width:203px;">269-29</td>
			<td>Induction agent</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">&#160;long blade for laryngoscope&#160;</td>
			<td style="width:223px;">DRE</td>
			<td>12521</td>
			<td>Allows for visualization of trachea for intubation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">ECG Pads</td>
			<td>DRE</td>
			<td>1496</td>
			<td>Monitor heart rhythm</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">laryngoscope&#160;</td>
			<td style="width:223px;">DRE</td>
			<td>12515</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Anesthesia Machine + ventilator</td>
			<td style="width:223px;">DRE Drager- Fabius Tiro</td>
			<td style="width:203px;">DRE0603FT</td>
			<td>Deliver Oxygen and inhalant to patient</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">&#160;5 Ethibond&#160;</td>
			<td>Ethicon</td>
			<td>MG46G</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">0 Vicryl</td>
			<td>Ethicon</td>
			<td>J208H</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">2-0 Vicryl</td>
			<td>Ethicon</td>
			<td>J317H</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">3-0 Vicryl</td>
			<td>Ethicon</td>
			<td>VCP824G</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">7-0 Prolene</td>
			<td>Ethicon</td>
			<td>M8702</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Dermabond</td>
			<td style="width:223px;">Ethicon</td>
			<td>DNX12</td>
			<td>Skin adhesive</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Ligaclips</td>
			<td>Ethicon</td>
			<td>MSC20</td>
			<td>Surgical Staples for LIMA takedown</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Sterile Saline 20 mL</td>
			<td>Fisher Scientific</td>
			<td>20T700220</td>
			<td>Flush for IV catheters</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Telazol 100 mg/mL</td>
			<td style="width:223px;">Fort Dodge</td>
			<td style="width:203px;">01L60030</td>
			<td>Pre operative Sedative</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Triple Antibiotic Ointment</td>
			<td style="width:223px;">Johnson &#38; Johnson</td>
			<td style="width:203px;">23734</td>
			<td>Topical over wound</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">6.0 mm ID endotracheal tube</td>
			<td>Mallinckrodt</td>
			<td>86049</td>
			<td>Establish airway for Revasc,MRI and Termination</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">1&#34; medical tape</td>
			<td style="width:223px;">Medline</td>
			<td>MMM15271Z</td>
			<td>Secure wound dressing and IV catheters</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">4.0 mm ID endotracheal tube</td>
			<td>Medline</td>
			<td>DYND43040</td>
			<td>Establish airway for Hibernation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">4.5 mm ID endotracheal tube</td>
			<td>Medline</td>
			<td>DYND43045</td>
			<td>Establish airway for Hibernation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">5.0 mm ID endotracheal tube</td>
			<td>Medline</td>
			<td>DYND43050</td>
			<td>Establish airway for Hibernation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">6.5 mm ID endotracheal tube</td>
			<td>Medline</td>
			<td>DYND43065</td>
			<td>Establish airway for Revasc,MRI and Termination</td>
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			<td height="21" style="height:21px;width:261px;">7.0 mm ID endotracheal tube</td>
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			<td>Establish airway for Revasc,MRI and Termination</td>
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			<td>AUG55501</td>
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			<td>Sterile drapes and table cover</td>
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			<td>1188100777</td>
			<td>Administer injectable agents</td>
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			<td>8881520657</td>
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			<td height="21" style="height:21px;width:261px;">3 mL Syinge</td>
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			<td>1180300555</td>
			<td>Administer injectable agents</td>
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		<tr height="21">
			<td height="21" style="height:21px;width:261px;">6&#160; mL Syringe</td>
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			<td>1180600777</td>
			<td>Administer injectable agents</td>
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		<tr height="21">
			<td height="21" style="height:21px;width:261px;">60 mL Syringe</td>
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			<td>8881560125</td>
			<td>Administer injectable agents</td>
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			<td height="21" style="height:21px;">Blower Mister Kit</td>
			<td>Medtronic/Covidien</td>
			<td>22120</td>
			<td>Clears surgical field for vessel anastomosis</td>
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			<td>078919-016-701</td>
			<td>Remove hair from surgery sites</td>
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			<td>078566-011-002</td>
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			<td>00409-1161-01</td>
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			<td>00409-0805-01</td>
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			<td>Neuromuscular blocking agent</td>
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			<td style="width:203px;">0536-1086-91</td>
			<td>Lubricate eyes to prevent corneal drying</td>
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		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Buprenorphine 0.3 mg/mL</td>
			<td style="width:223px;">Sigma Aldrich</td>
			<td style="width:203px;">B9275</td>
			<td>Pre operative Analgesic for survivial procedures</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Isoflurane</td>
			<td style="width:223px;">Sigma Aldrich</td>
			<td style="width:203px;">CDS019936</td>
			<td>General Anesthestic- Inhalant</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">36&#8221; Pressure monitoring tubing</td>
			<td>Smith&#8217;s Medical</td>
			<td>MX563</td>
			<td>Connect art. Line&#160; to transducer</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">48&#8221; Pressure monitoring tubing</td>
			<td>Smith&#8217;s Medical</td>
			<td>MX564</td>
			<td>Connect art. Line&#160; to transducer</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Jelco 18 ga IV catheter&#160;</td>
			<td style="width:223px;">Smiths medical</td>
			<td style="width:203px;">4054</td>
			<td>IV access in Revasc, MRI and Term</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Jelco 20 ga IV catheter</td>
			<td style="width:223px;">Smiths medical</td>
			<td style="width:203px;">4059</td>
			<td>IV access in the MRI</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Jelco 22 ga&#160; IV catheter</td>
			<td style="width:223px;">Smiths medical</td>
			<td>4050</td>
			<td>IV access in Hibernation Procedure</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">OPVAC Synergy II</td>
			<td>Terumo Cardiovascular System</td>
			<td>401-230</td>
			<td>Heart positioner and Stabilizer</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Sternal Saw/ Necropsy Saw</td>
			<td>Thermo Fisher</td>
			<td>812822</td>
			<td>Used to open chest cavity</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Delrin Constrictor</td>
			<td style="width:223px;">U of MN</td>
			<td style="width:203px;">Custom made</td>
			<td>Creates stenosis of LAD</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Oxygen Tank E cylinder</td>
			<td>various</td>
			<td>various</td>
			<td>Used for Blower Mister if anesthesia machine doesn&#39;t have auxiliary flow meter</td>
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		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Pressure Transducer</td>
			<td>various</td>
			<td>Must adapt to anesthesia monitor</td>
			<td>Monitor direct arterial pressures</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Xylazine 100 mg/mL</td>
			<td style="width:223px;">Vedco</td>
			<td style="width:203px;">468RX</td>
			<td>Pre operative Sedative/ analgesic</td>
		</tr>
	</tbody>
</table>

surgical swine model of chronic cardiac ischemia treated by off-pump coronary artery bypass graft surgery

Ischemia cardiaca cronica che altera la funzione cardiaca, ma non si traduca in infarto, viene definito il miocardio hibernating (HM). Un grande sottoinsieme clinico dei pazienti della coronaropatia (CAD) ha HM, che oltre a causare la funzione alterata, li mette a rischio per aritmie e futuri eventi cardiaci. Il trattamento standard per questa circostanza è rivascolarizzazione, ma questo ha dimostrato di essere una terapia imperfetta. La maggior parte della ricerca pre-clinica cardiaca si concentra sui modelli di infarto di ischemia cardiaca, lasciando questo sottoinsieme dei pazienti di ischemia cronica in gran parte scarsamente. Per colmare questa lacuna nella ricerca, abbiamo sviluppato un modello ben caratterizzato e altamente riproducibile del miocardio hibernating in maiali, come suina è modelli ideali traslazionali per la malattia di cuore umano. Oltre a creare questo modello di malattia unica, abbiamo ottimizzato un modello di trattamento clinicamente rilevanti della chirurgia di bypass coronarico in maiali. Questo ci permette con precisione studiare gli effetti dell'intervento di bypass sulla malattia cardiaca, come pure studiare terapie aggiuntive o alternative. Questo modello induce chirurgicamente stenosi singolo vaso impiantando un constrictor sull'arteria discendente anteriore sinistra (ragazzo) in un giovane maiale. Come cresce il maiale, il costrittore crea una stenosi progressiva, con conseguente ischemia cronica con alterata funzione regionale, ma preservare la vitalità dei tessuti. A seguito dell'istituzione del fenotipo miocardio ibernato, eseguiamo intervento di bypass coronarico fuori pompa per revascularize la regione ischemica, che imita il trattamento oro-standard per i pazienti della clinica.

Dopo l'intervento chirurgico iniziale sospensione, stenosi supera al 70% dovrebbe essere in grado di essere osservato da tecniche di imaging clinici come angiografia o cardiaco MRI (Figura 1A). 8 settimane dopo l'applicazione chirurgica del constrictor LAD, analisi della funzione regionale di ECHO o MRI cardiaco rivelano la funzione ridotta sotto carico di lavoro aumentato (Figura 2). Questo può essere testato s...

Watch this Scientific Journal Video about Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery at JoVE.com

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Questo protocollo presenta un modello animale grande chirurgico di ischemia cronica, singola nave che provoca anomalie regionali ma non crea infarto, conosciuto come il miocardio hibernating. Seguito istituzione di ischemia cronica, gli animali sono trattati con fuori-pompa LIMA-LAD bypass coronarico per revascularize tessuto ischemico.

Chirurgico suina modello di Ischemia cardiaca cronica trattato con intervento di Bypass coronarico fuori pompa

Chronic cardiac ischemia that impairs cardiac function, but does not result in infarct, is termed hibernating myocardium (HM). A large clinical subset of ...

Research

JoVE Journal

Medicine

Implantation of Inferior Vena Cava Interposition Graft in Mouse Model

L&#39;impianto di Vena cava inferiore Interposizione Graft in modello murino

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are often used for reconstructive surgery to treat congenital cardiac anomalies. ...

Ricerca

Medicina

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

Valutazione di un romanzo Laser-assistita coronarica anastomosi Connector - Clip Trinity - in un suino Off-pompa bypass Modello

To simplify and facilitate beating heart (i.e., off-pump), minimally invasive coronary artery bypass surgery, a new coronary anastomotic connector, the ...

Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice

Valutazione Ecografia base di coronaropatia Flow e flusso coronarico Reserve Utilizzando la pressione Sovraccarico modello nei topi

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow ...

Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency

Vena interposizione Modello: un modello adatto per studiare Bypass Graft pervietà

Bypass grafting is an established treatment method for coronary artery disease. Graft patency continues to be the Achilles heel of saphenous vein grafts. ...

A Chronic Cardiac Ischemia Model in Swine Using an Ameroid Constrictor

Un modello di Ischemia cardiaca cronica nei suini utilizzando un Constrictor Ameroid

Cardiovascular disease remains the number one cause of mortality in the United States. There are numerous approaches to treating these diseases, but ...

Brachial Artery Catheterization in Swine

Cateterizzazione dell'arteria brachiale in maiali

The video describes in detail the catheterization of the distal brachial artery in swine. This technique enables researchers to measure arterial blood ...

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

Modello di infarto miocardico Murine utilizzando la legatura permanente dell'arteria coronaria discendente anteriore sinistra

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

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Un modello animale di grandi dimensioni per lesioni renali acute da occlusione temporanea bilaterale dell'arteria renale

Acute kidney injury (AKI) is associated with higher risk for morbidity and mortality post-operatively. Ischemia-reperfusion injury (IRI) is the most ...

A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position

Un modello di roditore dell'operazione di Ross: impianto di innesto di arteria polmonare singenica in una posizione sistemica

The Ross operation for aortic valve disease has regained new interest due to its outstanding long-term results. Nonetheless, when employed as freestanding ...

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

Legatura coronaria sinistra: un modello chirurgico murino di infarto miocardico

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 ...