The authors are thankful to Colombe Roy, YanFen Shi, Sandra Querry, and Josiane Deslandes for the technical performance of transthoracic echocardiography and to Nathalie L&#39;Heureux for preliminary technical assistance during the standardization of the PAB method. We are grateful to the members of the animal care facility of the Montreal Heart Institute.

Optimizing Pulmonary Artery Banding for Consistent Right Heart Failure Induction

<ol>
	<li>Cassady, S. J., Ramani, G. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Right+heart+failure+in+pulmonary+hypertension.">Right heart failure in pulmonary hypertension.</a> Cardiol Clin. 38 (2), 243-255 (2020).</li><li>Campo, 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=Outcomes+of+hospitalization+for+right+heart+failure+in+pulmonary+arterial+hypertension.">Outcomes of hospitalization for right heart failure in pulmonary arterial hypertension.</a> Eur Respir J. 38 (2), 359-367 (2011).</li><li>Naeije, R., Manes, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+right+ventricle+in+pulmonary+arterial+hypertension.">The right ventricle in pulmonary arterial hypertension.</a> Eur Respir Rev. 23 (134), 476-487 (2014).</li><li>Vonk-Noordegraaf, 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=Right+heart+adaptation+to+pulmonary+arterial+hypertension:+physiology+and+pathobiology.">Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology.</a> J Am Coll Cardiol. 62 (25 Suppl), D22-D33 (2013).</li><li>Olsson, K. M., Nickel, N., Tongers, J., Hoeper, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Atrial+flutter+and+fibrillation+in+patients+with+pulmonary+hypertension.">Atrial flutter and fibrillation in patients with pulmonary hypertension.</a> Int J Cardiol. 167 (5), 2300-2305 (2013).</li><li>Mercurio, V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pulmonary+arterial+hypertension+and+atrial+arrhythmias:+incidence,+risk+factors,+and+clinical+impact.">Pulmonary arterial hypertension and atrial arrhythmias: incidence, risk factors, and clinical impact.</a> Pulm Circ. 8 (2), 2045894018769874 (2018).</li><li>Dignam, J. P., Scott, T., Kemp-Harper, B., Hobbs, A. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Animal+models+of+pulmonary+hypertension:+Getting+to+the+heart+of+the+problem.">Animal models of pulmonary hypertension: Getting to the heart of the problem.</a> Br J Pharmacol. 179 (5), 811-837 (2021).</li><li>Silva, A. 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=Monocrotaline+induces+acutely+cerebrovascular+lesions,+astrogliosis+and+neuronal+degeneration+associated+with+behavior+changes+in+rats:+A+model+of+vascular+damage+in+perspective.">Monocrotaline induces acutely cerebrovascular lesions, astrogliosis and neuronal degeneration associated with behavior changes in rats: A model of vascular damage in perspective.</a> Neurotoxicology. 94, 59-70 (2023).</li><li>Hiram, R., 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=Right+atrial+mechanisms+of+atrial+fibrillation+in+a+rat+model+of+right+heart+disease.">Right atrial mechanisms of atrial fibrillation in a rat model of right heart disease.</a> J Am Coll Cardiol. 74 (10), 1332-1347 (2019).</li><li>Hirata, M., 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=Novel+model+of+pulmonary+artery+banding+leading+to+right+heart+failure+in+rats.">Novel model of pulmonary artery banding leading to right heart failure in rats.</a> Biomed Res Int. 2015, 753210 (2015).</li><li>Jalal, Z., 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=Unexpected+internalization+of+a+pulmonary+artery+band+in+a+porcine+model+of+tetralogy+of+Fallot.">Unexpected internalization of a pulmonary artery band in a porcine model of tetralogy of Fallot.</a> World J Pediatr Congenit Heart Surg. 8 (1), 48-54 (2017).</li><li>Akazawa, Y., 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=Pulmonary+artery+banding+is+a+relevant+model+to+study+the+right+ventricular+remodeling+and+dysfunction+that+occurs+in+pulmonary+arterial+hypertension.">Pulmonary artery banding is a relevant model to study the right ventricular remodeling and dysfunction that occurs in pulmonary arterial hypertension.</a> J Appl Physiol. 129 (2), 238-246 (2020).</li><li>Le Quilliec, 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=Atrial+cardiomyocytes+contribute+to+the+inflammatory+status+associated+with+atrial+fibrillation+in+right+heart+disease.">Atrial cardiomyocytes contribute to the inflammatory status associated with atrial fibrillation in right heart disease.</a> Europace. 26 (4), euae082 (2024).</li><li>Cheng, H. W., 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=Assessment+of+right+ventricular+structure+and+function+in+mouse+model+of+pulmonary+artery+constriction+by+transthoracic+echocardiography.">Assessment of right ventricular structure and function in mouse model of pulmonary artery constriction by transthoracic echocardiography.</a> J Vis Exp. (84), e51041 (2014).</li><li>Cheng, T. C., Philip, J. L., Tabima, D. M., Hacker, T. A., Chesler, N. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiscale+structure-function+relationships+in+right+ventricular+failure+due+to+pressure+overload.">Multiscale structure-function relationships in right ventricular failure due to pressure overload.</a> Am J Physiol Heart Circ Physiol. 315 (3), H699-H708 (2018).</li><li>Mamazhakypov, A., Veith, C., Schermuly, R. T., Sydykov, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+protocol+for+pulmonary+artery+banding+in+mice+to+generate+a+model+of+pressure-overload-induced+right+ventricular+failure.">Surgical protocol for pulmonary artery banding in mice to generate a model of pressure-overload-induced right ventricular failure.</a> STAR Protoc. 4 (4), 102660 (2023).</li><li>Prihadi, E. 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=Morphologic+types+of+tricuspid+regurgitation.+Characteristics+and+prognostic+implications.">Morphologic types of tricuspid regurgitation. Characteristics and prognostic implications.</a> JACC: Cardiovasc Imaging. 12 (3), 491-499 (2019).</li><li>Samson, N., Paulin, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Epigenetics,+inflammation+and+metabolism+in+right+heart+failure+associated+with+pulmonary+hypertension.">Epigenetics, inflammation and metabolism in right heart failure associated with pulmonary hypertension.</a> Pulm Circ. 7 (3), 572-587 (2017).</li><li>Liu, Z., 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=Low-voltage+zones+as+the+atrial+fibrillation+substrates:+Relationship+With+initiation,+perpetuation,+and+termination.">Low-voltage zones as the atrial fibrillation substrates: Relationship With initiation, perpetuation, and termination.</a> Front Cardiovasc Med. 8, 705510 (2021).</li><li>Tomasello, G., 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=Simple+and+fast+orotracheal+intubation+procedure+in+rats.">Simple and fast orotracheal intubation procedure in rats.</a> Acta Biomed. 87 (1), 13-15 (2016).</li><li>Hala&#539;iu, V. B., Perian, M., Balan, A. I., Scridon, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transesophageal+atrial+burst+pacing+for+atrial+fibrillation+induction+in+rats.">Transesophageal atrial burst pacing for atrial fibrillation induction in rats.</a> J Vis Exp. (180), e63567 (2022).</li><li>Prophet, E. B., Mills, B., Arrington, J. B., Sobin, L. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Laboratory Methods in Histotechnology. , (1992).</li><li>Silva, J. M. 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=Hypertrophy+of+the+right+ventricle+by+pulmonary+artery+banding+in+rats:+a+study+of+structural,+functional,+and+transcriptomics+alterations+in+the+right+and+left+ventricles.">Hypertrophy of the right ventricle by pulmonary artery banding in rats: a study of structural, functional, and transcriptomics alterations in the right and left ventricles.</a> Front Physiol. 14, 1129333 (2023).</li><li>Camacho, P., Fan, H., Liu, Z., He, J. Q. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Small+mammalian+animal+models+of+heart+disease.">Small mammalian animal models of heart disease.</a> Am J Cardiovasc Dis. 6 (3), 70-80 (2016).</li><li>Andersen, S., 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=A+pulmonary+trunk+banding+model+of+pressure+overload+induced+right+ventricular+hypertrophy+and+failure.">A pulmonary trunk banding model of pressure overload induced right ventricular hypertrophy and failure.</a> J Vis Exp. (141), e58050 (2018).</li><li>Ukita, R., 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=A+large+animal+model+for+pulmonary+hypertension+and+right+ventricular+failure:+Left+pulmonary+artery+ligation+and+progressive+main+pulmonary+artery+banding+in+sheep.">A large animal model for pulmonary hypertension and right ventricular failure: Left pulmonary artery ligation and progressive main pulmonary artery banding in sheep.</a> J Vis Exp. (173), e62694 (2021).</li><li>Myers, P. 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=Impact+of+age+and+duration+of+banding+on+left+ventricular+preparation+before+anatomic+repair+for+congenitally+corrected+transposition+of+the+great+arteries.">Impact of age and duration of banding on left ventricular preparation before anatomic repair for congenitally corrected transposition of the great arteries.</a> Ann Thorac Surg. 96 (2), 603-610 (2013).</li><li>Liu, C., 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=Reverse+remodeling+of+pulmonary+arterioles+after+pulmonary+artery+banding+in+patients+&#8805;+2+years+old+with+severe+pulmonary+arterial+hypertension+and+congenital+heart+disease.">Reverse remodeling of pulmonary arterioles after pulmonary artery banding in patients &#8805; 2 years old with severe pulmonary arterial hypertension and congenital heart disease.</a> Pediatr Cardiol. 40 (5), 958-964 (2019).</li><li>Roy, B., Vacas, S., Ehlert, L., McCloy, K., Saggar, R., Kumar, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Brain+structural+changes+in+patients+with+pulmonary+arterial+hypertension.">Brain structural changes in patients with pulmonary arterial hypertension.</a> J Neuroimaging. 31 (3), 524-531 (2021).</li><li>Hiram, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resolution-promoting+autacoids+demonstrate+promising+cardioprotective+effects+against+heart+diseases.">Resolution-promoting autacoids demonstrate promising cardioprotective effects against heart diseases.</a> Mol Biol Rep. 49 (6), 5179-5197 (2022).</li><li>Hiram, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiac+cytokine+therapy?+Relevance+of+targeting+inflammatory+mediators+to+combat+cardiac+arrhythmogenic+remodeling.">Cardiac cytokine therapy? Relevance of targeting inflammatory mediators to combat cardiac arrhythmogenic remodeling.</a> Int J Cardiol Heart Vasc. 37, 100918 (2021).</li><li>Al-U'datt, D. G. 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=Implications+of+enigmatic+transglutaminase+2+(TG2)+in+cardiac+diseases+and+therapeutic+developments.">Implications of enigmatic transglutaminase 2 (TG2) in cardiac diseases and therapeutic developments.</a> Biochem Pharmacol. 201, 115104 (2022).</li></ol>

The authors have nothing to disclose.

The successful performance of the PAB is the most crucial part of this protocol. It is important to properly distinguish the aorta and the PA trunk. The isolation of the PA must be performed meticulously to avoid tearing, bleeding, and death during the procedure. The application of the suture around the 19G lead must be performed quickly and followed by immediate removal of the lead, to avoid too long &#39;complete obstruction&#39; of the PA due to the presence of the lead.
According to the re...

Right heart failure (RHF) is characterized by right ventricular (RV) and atrial (RA) hypertrophy and dilation, leading to right-sided cardiac malfunction in response to chronic RV pressure overload due to the constriction of the pulmonary arteries (PA)1. Hence, conditions provoking the narrowing of PA can be responsible for an increased risk of RHF1,2,3,4. Clinical data revealed that RHF is the major cause of hospitalization (56%) in patients with PA hypertension (PAH)2. Clinical studies have shown that independent of the cause of PAH, including thromboembolic pulmonary hypertension (PH) and idiopathic PAH, patients are often affected by RHF and are 20% more susceptible to developing cardiac arrhythmias including supraventricular tachyarrhythmias and atrial fibrillation (AF)2,5,6.
To better understand the association between PAH and RHF, animal studies, including the model of a single dose of monocrotaline (MCT), have been used to provoke severe lung inflammation and RHF7,8. We recently observed that MCT-induced RHF was associated with RA inflammation and AF9. However, due to the importance of MCT-induced pulmonary inflammation and circulating cytokines, it was difficult to describe whether MCT-induced RA inflammation is a consequence of RHF only9. Hence, a new model of RHF-induced cardiac arrhythmia was required to study the RA inflammatory status.
The PA trunk banding (PAB) experimental model has been used in various animal species to mimic obstructive PA diseases and to study the associated pathological cardiac remodeling affecting the right side of the heart10. PAB has been reported as an effective method to induce right RV dysfunction and failure in various studies mimicking RV overload10,11,12,13,14,15,16. Technically, PAB is the placement of a permanent suture on the PA trunk, provoking a mechanical reduction of the PA trunk diameter10. PAB generates an increased pressure overload to the RV10. First, as a compensatory adaptation to the sudden increase in RV afterload, the RV cavity is dilated, leading to chronic RV hypertrophy10,13. RV dilation and hypertrophy affect the tricuspid valves, which become leaky13. More precisely, the pronounced dilation of the RV combined with high RV afterload has the effect of stretching the tricuspid valve annulus located between the RV and the RA13,17. Due to the incomplete occlusion of the valve, a portion of the blood ejected from the RV during systole will be directed toward the RA cavity17. Leakage of the tricuspid valve can be observed through echocardiography and is called tricuspid regurgitation17. Then, the RA receives inappropriately high blood pressure, contributing to increased RA dilation and hypertrophy13. The chronic RV and RA remodeling are accompanied by local myocardial inflammatory reactions leading to RV and RA fibrosis and loss of function9,13. Cardiac fibrosis is characterized by the development of low-voltage zones that are less contractile and more susceptible to provoking conduction block and re-entry circuits involved in the development of cardiac arrhythmias, including ventricular fibrillation and AF18,19.
The originality of this paper resides in the utilization of a standardized method of PAB-induced right-sided cardiac remodeling to provoke and study cardiac arrhythmias inducibility in 3 weeks post-PAB. The main advantages of this surgical approach are: i) the direct control over the reduction of the PA trunk diameter and ii) the avoidance of pulmonary inflammation to focus on RHF-induced myocardial inflammation to study cardiac arrhythmias, including AF.
The approach described here involves a precise microsurgical procedure to create the PAB, assessment of increased RV afterload, echocardiography to observe PAB-induced myocardial structural and functional remodeling, and electrophysiological study to evaluate vulnerability to cardiac arrhythmias, including AF.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>0.9% Sodium Chlorine Injection USB (100 ml)&#160;</td>
			<td>Baxter</td>
			<td>JB1302P</td>
			<td>Solution used for drugs (analgesic and anti-inflammatory) dilution and for preparing saline water syringes dedicated to rehydrating the animal after the surgery</td>
		</tr>
		<tr>
			<td>19 G x 1 1/2 PrecisionGlide Needle</td>
			<td>BD</td>
			<td>305187</td>
			<td>Needle modified (bent and blunted) to be used as a spacer during for the partial constriction of the pulmonary trunk</td>
		</tr>
		<tr>
			<td>2&#34; x 2&#34; Non Woven Non-Sterile Ritmed Gauze Sponge, 4-Ply</td>
			<td>AMD-Ritmed</td>
			<td>A2101-CH</td>
			<td>Gauze sponges used to absorb blood from the wound or to gently push organs (ex: thymus) aside.</td>
		</tr>
		<tr>
			<td>4&#34; x 4&#34; Non Woven Non-Sterile Ritmed Gauze Sponge, 4-Ply (x200)</td>
			<td>AMD-Ritmed</td>
			<td>A2100-CH</td>
			<td>Gauze sponges used to absorb blood from the wound or to gently push organs (ex: thymus) aside.</td>
		</tr>
		<tr>
			<td>5-0 Vicryl Violet Suture RB-1 1/2 Circle Needle 17mm 27&#34;</td>
			<td>Ethicon</td>
			<td>J303H</td>
			<td>Synthetic absorbable sterile surgical suture with a taperpoint needle used for muscle and skin wounds closure.</td>
		</tr>
		<tr>
			<td>Anafen (100 mg/mL)</td>
			<td>Merial Canada, Inc.</td>
			<td>1938126</td>
			<td>Diluted injectable solution of ketoprofen administered as a nonsteroidal anti-inflammatory, analgesic and antipyretic drug.</td>
		</tr>
		<tr>
			<td>AutoClip&#160;System</td>
			<td>FST</td>
			<td>12020-00</td>
			<td>Can be used to close the skin wound. Includes a clip applier, wound clips (9 mm) and a clip remover.</td>
		</tr>
		<tr>
			<td>Dumont #5/45 Forceps</td>
			<td>FST</td>
			<td>11251-35</td>
			<td>Dumoxel forceps with tips angled at 45&#176;. Used to tighten the knots around the spacer placed on the pulmonary trunk.</td>
		</tr>
		<tr>
			<td>Fine Scissors - Sharp</td>
			<td>FST</td>
			<td>14060-10</td>
			<td>Stainless steel iris scissors dedicated to intercostal muscles incision and suture cutting.</td>
		</tr>
		<tr>
			<td>Forane (Isoflurane) 100 mL</td>
			<td>Baxter Canada</td>
			<td>BAXCA2L9100</td>
			<td>Inhalation anesthetic used for rodents during their PAB surgery.</td>
		</tr>
		<tr>
			<td>IV Catheter 16 G x 1.77 &#34; (Straight)</td>
			<td>BD Insyte</td>
			<td>381257</td>
			<td>Catheter used as an endotracheal tube with its metal stylet blunted.</td>
		</tr>
		<tr>
			<td>Light&#160; LED 130 F - DrMach</td>
			<td>Eickemeyer</td>
			<td>M130300</td>
			<td>LED wall mounted light.</td>
		</tr>
		<tr>
			<td>Magnetic Fixator Retraction System: Base plate</td>
			<td>FST</td>
			<td>18200-50</td>
			<td>Metal plate on which the associated fixtures are installed. It is placed around the heating plate.</td>
		</tr>
		<tr>
			<td>Magnetic Fixator Retraction System: Elastomer (2 m Roll)</td>
			<td>FST</td>
			<td>18200-07</td>
			<td>Used to attach the retractors to the fixators.</td>
		</tr>
		<tr>
			<td>Magnetic Fixator Retraction System: Fixators</td>
			<td>FST</td>
			<td>18200-02</td>
			<td>Movable anchors that can be placed on the base plate.</td>
		</tr>
		<tr>
			<td>Magnetic Fixator Retraction System: Retractors</td>
			<td>FST</td>
			<td>18200-11</td>
			<td>Retractors allowing to maintain the surgical wound with the desired opening</td>
		</tr>
		<tr>
			<td>Metzenbaum Scissors (Curved)</td>
			<td>FST</td>
			<td>14017-14</td>
			<td>Stainless steel blunt scissors used for blunt dissection of the skin and muscles.</td>
		</tr>
		<tr>
			<td>Micro-Adson Forceps</td>
			<td>FST</td>
			<td>11018-12</td>
			<td>Stainless steel serrated forceps used to grasp skin and other tissues.</td>
		</tr>
		<tr>
			<td>Oster Golden A5 2-Speed Clipper</td>
			<td>Oster Professional</td>
			<td>34264416949</td>
			<td>Pet grooming clipper used to prepare the surgical field. Since it&#39;s meant to be used with large animals, the user needs to be careful with rats.</td>
		</tr>
		<tr>
			<td>Rodent heating plate or warming system</td>
			<td>Custom made</td>
			<td>N/A</td>
			<td>Plate connected to a unit equipped with a LED screen displaying the temperature detected by the rectal probe as well as the target temperature.</td>
		</tr>
		<tr>
			<td>Rodent Ventilator Model 683</td>
			<td>Harvard Apparatus</td>
			<td>74240-2</td>
			<td>Mechanical ventilator used for small laboratory animals (max 5 kg).</td>
		</tr>
		<tr>
			<td>Semken Forceps with Serrations (Curved)</td>
			<td>FST</td>
			<td>11009-13</td>
			<td>Stainless steel forceps used for tissue dissection.</td>
		</tr>
		<tr>
			<td>Semken Forceps with Serrations (Straight)</td>
			<td>FST</td>
			<td>11008-13</td>
			<td>Stainless steel forceps used for tissue dissection.</td>
		</tr>
		<tr>
			<td>Silky Fresh Hair removal Cream</td>
			<td>Veet</td>
			<td>62200825036</td>
			<td>Hair removal product used to prepare the surgical site after shaving.</td>
		</tr>
		<tr>
			<td>Soluprep&#160;</td>
			<td>3M</td>
			<td>103.26</td>
			<td>Bottled antiseptic solution tinted with 2% chlorhexidine and 70 % alcohol 225 mL.</td>
		</tr>
		<tr>
			<td>Stainless steel spatula 195 mm</td>
			<td>Heathrow Scientific</td>
			<td>HS15907</td>
			<td>Spatula used as a tongue depressor during rat intubation.</td>
		</tr>
		<tr>
			<td>Stereomicroscope System SZ61TR</td>
			<td>Olympus</td>
			<td>88-126</td>
			<td>Microscope equipped with binoculars and a built-in camera allowing for video filming.</td>
		</tr>
		<tr>
			<td>Sterile Sodium Chloride 0.9% Irrigation Bottle (60 mL)</td>
			<td>Saline H2O</td>
			<td>25-6048SA-L</td>
			<td>Solution used to keep the wound moist throughout the surgery.</td>
		</tr>
		<tr>
			<td>Surgical Scissors - Sharp-Blunt (Straight)</td>
			<td>FST</td>
			<td>14001-12</td>
			<td>Stainless steel scissors used to make the initial skin incision.</td>
		</tr>
		<tr>
			<td>Suture 5-0 Silk No Needle</td>
			<td>Henry Schein</td>
			<td>102-6344</td>
			<td>Silk thread used to do the constriction of the pulmonary trunk</td>
		</tr>
		<tr>
			<td>Systane Ointment</td>
			<td>Alcon</td>
			<td>2444062</td>
			<td>Eyes lubricant providing a temporary relief of burning and irritation caused by the dryness of the eyes during surgery.</td>
		</tr>
		<tr>
			<td>SZ2-STU2 stereomicroscope stand</td>
			<td>Olympus</td>
			<td>N1198900</td>
			<td>The arm attached to the base provides a great freedom of movement to the microscope head.</td>
		</tr>
		<tr>
			<td>Tissue forceps - 1X2 Teeth</td>
			<td>FST</td>
			<td>11021-15</td>
			<td>Stainless steel forceps allowing to grasp, hold and manipulate tissues (skin and muscles).</td>
		</tr>
		<tr>
			<td>Transpore Surgical Tape</td>
			<td>3M</td>
			<td>1527-1</td>
			<td>Medical tape used to immobilized the rats&#39; forelimbs and hindlimbs.</td>
		</tr>
		<tr>
			<td>Vetbond Tissue Adhesive (3 mL)</td>
			<td>3M</td>
			<td>1469SB</td>
			<td>Surgical glue that can be applied in small amounts on the skin It can be used as a complement to subcutaneous sutures.</td>
		</tr>
		<tr>
			<td>Vetergesic Multidose (0.3 mg/mL) 10 mL</td>
			<td>Ceva Canada</td>
			<td>2342510</td>
			<td>Diluted injectable solution of buprenorphine administered as an analgesic drug.</td>
		</tr>
		<tr>
			<td>Veterinary anesthesia evaporator Tec 4</td>
			<td>Dispomed</td>
			<td>34001 Iso</td>
			<td>Enables vaporization of isoflurane and concentration at 0&#8211;5%.</td>
		</tr>
	</tbody>
</table>

rat model of right-sided cardiac remodeling and arrhythmia using pulmonary artery banding

Clinical conditions, including chronic obstructive pulmonary disease or pulmonary arterial hypertension (PAH), can lead to chronic right ventricle pressure overload and progressive right heart failure (RHF). RHF can be identified by right-sided cardiac hypertrophy and dilation associated with abnormal myocardial function affecting the RV and the right atrium (RA). We recently demonstrated that severe RHF is accompanied by an increased risk of atrial inflammation, atrial fibrosis, and atrial fibrillation (AF), the most common type of cardiac arrhythmia (CA). Recent studies have shown that RV and RA inflammation plays an important role in the arrhythmogenesis of CA, including AF. However, the impact of inflammation in the development of CA and AF in RHF is poorly described.
Experimental models of RHF are required to better understand the association between right-sided myocardial inflammation and CA. The rat model of monocrotaline (MCT)-induced pulmonary hypertension (PH) is well-established to provoke RHF. However, MCT triggers severe pneumo-toxicity and pulmonary inflammation. Hence, MCT-induced RHF does not help to distinguish whether the subsequent myocardial inflammation originates from the RHF per se or circulating inflammatory signals secreted by the injured lung.
In this article, a mechanical method involving pulmonary artery trunk banding (PAB) was used to provoke right-sided cardiac arrhythmogenesis. The PAB consists of performing a permanent suture of the pulmonary artery trunk for 3 weeks. Such an approach generates increased right-sided pressure overload. At D21 post-PAB, the suture results in hypertrophied, dilated, and inflamed RV and RA. The PAB-induced RHF is also accompanied by vulnerability to ventricular and atrial arrhythmias, including AF.

Visual confirmation of the appropriate ligation of the PA trunk during surgery 
During the PAB procedure, an indication of good positioning of the suture is an immediate augmentation of the blood pressure and prompt dilation of the RV and the root of the PA -trunk at the junction with the RV. The suture must not move to ensure a constant and permanent pressure overload for 3 weeks. In this study, the use of a 5-0 Silk was validated as more stable than a metal clip (Figure 2E</st...

Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding

Right heart failure (RHF) is characterized by right-sided cardiac dilation and hypertrophy, leading to ventricular and atrial malfunction. Cardiopulmonary conditions associated with RHF are accompanied by an increased risk for cardiac arrhythmias. This article describes a standardized model of pulmonary artery banding-induced RHF associated with enhanced ventricular and atrial arrhythmogenesis.

Clinical conditions, including chronic obstructive pulmonary disease or pulmonary arterial hypertension (PAH), can lead to chronic right ventricle ...

rat-model-right-sided-cardiac-remodeling-arrhythmia-using-pulmonary

Research

JoVE Journal

Medicine

445 Views.  Montreal Heart Institute. Right heart failure (RHF) is characterized by right-sided cardiac dilation and hypertrophy, leading to ventricular and atrial malfunction. Cardiopulmonary conditions associated with RHF are accompanied by an increased risk for cardiac arrhythmias. This article describes a standardized model of pulmonary artery banding-induced RHF associated with enhanced ventricular and atrial arrhythmogenesis.

Video: Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding

Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures

New remote navigation systems have been developed to improve current limitations of conventional manually guided catheter ablation in complex cardiac substrates such as left atrial flutter. This protocol describes all the clinical and invasive interventional steps performed during a human electrophysiological study and ablation to assess the accuracy, safety and real-time navigation of the Catheter Guidance, Control and Imaging (CGCI) system. Patients who underwent ablation of a right or left atrium flutter substrate were included. Specifically, data from three left atrial flutter and two counterclockwise right atrial flutter procedures are shown in this report. One representative left atrial flutter procedure is shown in the movie. This system is based on eight coil-core electromagnets, which generate a dynamic magnetic field focused on the heart. Remote navigation by rapid changes (msec) in the magnetic field magnitude and a very flexible magnetized catheter allow real-time closed-loop integration and accurate, stable positioning and ablation of the arrhythmogenic substrate.

This report provides a detailed description of a new remote navigation system based on magnetic driven forces, which has been recently introduced as a new robotic tool for human cardiac electrophysiology procedures.

New remote navigation systems have been developed to improve current limitations of conventional manually guided catheter ablation in complex cardiac ...

Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography

Emerging clinical data support the notion that RV dysfunction is critical to the pathogenesis of cardiovascular disease and heart failure1-3. Moreover, the RV is significantly affected in pulmonary diseases such as pulmonary artery hypertension (PAH). In addition, the RV is remarkably sensitive to cardiac pathologies, including left ventricular (LV) dysfunction, valvular disease or RV infarction4. To understand the role of RV in the pathogenesis of cardiac diseases, a reliable and noninvasive method to access the RV structurally and functionally is essential.
A noninvasive trans-thoracic echocardiography (TTE) based methodology was established and validated for monitoring dynamic changes in RV structure and function in adult mice. To impose RV stress, we employed a surgical model of pulmonary artery constriction (PAC) and measured the RV response over a 7-day period using a high-frequency ultrasound microimaging system. Sham operated mice were used as controls. Images were acquired in lightly anesthetized mice at baseline (before surgery), day 0 (immediately post-surgery), day 3, and day 7 (post-surgery). Data was analyzed offline using software.
Several acoustic windows (B, M, and Color Doppler modes), which can be consistently obtained in mice, allowed for reliable and reproducible measurement of RV structure (including RV wall thickness, end-diastolic&#160;and end-systolic dimensions), and function (fractional area change, fractional shortening, PA peak velocity, and peak pressure gradient) in normal mice and following PAC.
Using this method, the pressure-gradient resulting from PAC was accurately measured in real-time using Color Doppler mode and was comparable to direct pressure measurements performed with a Millar high-fidelity microtip catheter. Taken together, these data demonstrate that RV measurements obtained from various complimentary views using echocardiography are reliable, reproducible and can provide insights regarding RV structure and function. This method will enable a better understanding of the role of RV cardiac dysfunction.

Right ventricle (RV) dysfunction is critical to the pathogenesis of cardiovascular disease, yet limited methodologies are available for its evaluation. Recent advances in ultrasound imaging provide a noninvasive and accurate option for longitudinal RV study. Herein, we detail a step-by-step echocardiographic method using a murine model of RV pressure overload.

Emerging clinical data support the notion that RV dysfunction is critical to the pathogenesis of cardiovascular disease and heart failure1-3. Moreover, ...

Visualization of Streptococcus pneumoniae within Cardiac Microlesions and Subsequent Cardiac Remodeling

During bacteremia Streptococcus pneumoniae can translocate across the vascular endothelium into the myocardium and form discrete bacteria-filled microscopic lesions (microlesions) that are remarkable due to the absence of infiltrating immune cells. Due to their release of cardiotoxic products, S. pneumoniae within microlesions are thought to contribute to the heart failure that is frequently observed during fulminate invasive pneumococcal disease in adults. Herein is demonstrated a protocol for experimental mouse infection that leads to reproducible cardiac microlesion formation within 30 hr. Instruction is provided on microlesion identification in hematoxylin &#38; eosin stained heart sections and the morphological distinctions between early and late microlesions are highlighted. Instruction is provided on a protocol for verification of S. pneumoniae within microlesions using antibodies against pneumococcal capsular polysaccharide and immunofluorescent microscopy. Last, a protocol for antibiotic intervention that rescues infected mice and for the detection and assessment of scar formation in the hearts of convalescent mice is provided. Together, these protocols will facilitate the investigation of the molecular mechanisms underlying pneumococcal cardiac invasion, cardiomyocyte death, cardiac remodeling as a result of exposure to S. pneumoniae, and the immune response to the pneumococci in the heart.

Visualization of Streptococcus pneumoniae within Cardiac Microlesions and Subsequent Cardiac Remodeling

Streptococcus pneumoniae forms discrete non-purulent microscopic lesions in the heart. Outlined is the protocol for a murine model of cardiac microlesion formation. Instruction is provided on microlesion visualization using microscopy, discrimination between early and late microlesions, and methods to detect cardiac remodeling in hearts of convalescent animals.

During bacteremia Streptococcus pneumoniae can translocate across the vascular endothelium into the myocardium and form discrete bacteria-filled ...

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

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow reserve (CFR) in humans. Reduced CFR is accompanied by marked intramyocardial and pericoronary fibrosis and is used as an indication of the severity of dysfunction. This study explores, step-by-step, the real-time changes measured in the coronary flow velocity, CFR and systolic to diastolic peak velocity (S/D) ratio in the setting of an aortic banding model in mice. By using a Doppler transthoracic imaging technique that yields reproducible and reliable data, the method assesses changes in flow in the septal coronary artery (SCA), for a period of over two weeks in mice, that previously either underwent aortic banding or thoracotomy. 
During imaging, hyperemia in all mice was induced by isoflurane, an anesthetic that increased coronary flow velocity when compared with resting flow. All images were acquired by a single imager. Two ratios, (1) CFR, the ratio between hyperemic and baseline flow velocities, and (2) systolic (S) to diastolic (D) flow were determined, using a proprietary software and by two independent observers. Importantly, the observed changes in coronary flow preceded LV dysfunction as evidenced by normal LV mass and fractional shortening (FS). 
The method was benchmarked against the current gold standard of coronary assessment, histopathology. The latter technique showed clear pathologic changes in the coronary artery in the form of peri-coronary fibrosis that correlated to the flow changes as assessed by echocardiography. 
The study underscores the value of using a non-invasive technique to monitor coronary circulation in mouse hearts. The method minimizes redundant use of research animals and demonstrates that advanced ultrasound-based indices, such as CFR and S/D ratios, can serve as viable diagnostic tools in a variety of investigational protocols including drug studies and the study of genetically modified strains.

Coronary flow reserve (CFR) is useful for assessment of myocardial oxygen demand and evaluation of cardiovascular risk. This study establishes a step-by-step transthoracic Doppler echocardiographic (TTDE) method for longitudinal monitoring of the changes in CFR, as measured from coronary artery in mice, under the experimental pressure overload of aortic banding.

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

A Rat Carotid Balloon Injury Model to Test Anti-vascular Remodeling Therapeutics

The rat carotid balloon injury is a well-established surgical model that has been used to study arterial remodeling and vascular cell proliferation. It is also a valuable model system to test, and to evaluate therapeutics and drugs that negate maladaptive remodeling in the vessel. The injury, or barotrauma, in the vessel lumen caused by an inflated balloon via an inserted catheter induces subsequent neointimal growth, often leading to hyperplasia or thickening of the vessel wall that narrows, or obstructs the lumen. The method described here is sufficiently sensitive, and the results can be obtained in relatively short time (2 weeks after the surgery). The efficacy of the drug or therapeutic against the induced-remodeling can be evaluated either by the post-mortem pathological and histomorphological analysis, or by ultrasound sonography in live animals. In addition, this model system has also been used to determine the therapeutic window or the time course of the administered drug. These studies can leadto the development of a better administrative strategy and a better therapeutic outcome. The procedure described here provides a tool for translational studies that bring drug and therapeutic candidates from bench research to clinical applications.

The rat carotid balloon injury model described below allows researchers to evaluate drugs or therapeutics that negate injury-induced arterial hyperplasia. Detailed pre-surgical preparation, surgical procedure, and post-surgical cares of the animal are described.

The rat carotid balloon injury is a well-established surgical model that has been used to study arterial remodeling and vascular cell proliferation. It is ...

A Model of Cardiac Remodeling Through Constriction of the Abdominal Aorta in Rats

Heart failure is one of the leading causes of death worldwide. It is a complex clinical syndromethat includes fatigue, dyspnea, exercise intolerance, and fluid retention. Changes in myocardial structure, electrical conduction, and energy metabolism develop with heart failure, leading to contractile dysfunction, increased risk of arrhythmias, and sudden death. Hypertensive heart disease is one of the key contributing factors of cardiac remodeling associated with heart failure. The most commonly-used animal model mimicking hypertensive heart disease is created via surgical interventions, such as by narrowing the aorta. Abdominal aortic constriction is a useful experimental technique to induce a pressure overload, which leads to heart failure. The surgery can be easily performed, without the need for chest opening or mechanical ventilation. Abdominal aortic constriction-induced cardiac pathology progresses gradually, making this model relevant to clinical hypertensive heart failure. Cardiac injury and remodeling can be observed 10 weeks after the surgery. The method described here provides a simple and effective approach to produce a hypertensive heart disease animal model that is suitable for studying disease mechanisms and for testing novel therapeutics.

A rat model of abdominal aortic constriction that induces cardiac hypertrophy and remodeling is described. An efficient, highly-reproducible, and minimally-invasive method is used to provide a simple yet useful platform for research in myocardial hypertrophy and dysfunction.

Heart failure is one of the leading causes of death worldwide. It is a complex clinical syndromethat includes fatigue, dyspnea, exercise intolerance, and ...

Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery

The present methodology teaches the investigator how to measure and use the LAV as a surrogate of chronic elevations in Left Ventricular diastolic pressure through echocardiography, as well as to obtain measurements of the Aorta and PA diameter in mice.
Mice older than 10 d of age can be analyzed using the present technique. The technique is composed of 3 main steps: set-up, image acquisition, and image analysis. The set-up step consists of getting the mouse anesthetized with 1% isoflurane, shaving it, and taping it in a supine position to a heated EKG board where the image acquisition will take place. The image acquisition step consists of learning to identify the cardiac structures and obtaining all the required images with its correspondent probe and axis in order to be able to calculate volumes and diameters. The image analysis step consists of measuring the previously acquired images with the aid of computer software.
Advantages of the proposed technique include a fast (15 min) procedure that would allow the researcher to evaluate interventions in a non-invasive, non-terminal approach and therefore follow the same mouse over time; each mouse can be used as its own control. This fact plus having the same operator perform all the acquisition and analysis for the entire experiment minimizes the limitation of operator-dependency. The present methodology is useful for mouse researchers in cardiovascular and pulmonary medicine.

The following protocol describes the methodology for the acquisition and analysis of echocardiographic images used to obtain the Left Atrial Volume (LAV), Aorta (Ao) diameter, and Pulmonary Artery (PA) diameter in mice. This technique is a non-invasive, non-terminal procedure that allows assessment of the cardiopulmonary function.

The present methodology teaches the investigator how to measure and use the LAV as a surrogate of chronic elevations in Left Ventricular diastolic ...

A Pulmonary Trunk Banding Model of Pressure Overload Induced Right Ventricular Hypertrophy and Failure

Right ventricular (RV) failure induced by sustained pressure overload is a major contributor to morbidity and mortality in several cardiopulmonary disorders. Reliable and reproducible animal models of RV failure are therefore warranted in order to investigate disease mechanisms and effects of potential therapeutic strategies. Banding of the pulmonary trunk is a common method to induce isolated RV hypertrophy but in general, previously described models have not succeeded in creating a stable model of RV hypertrophy and failure.
We present a rat model of pressure overload induced RV hypertrophy caused by pulmonary trunk banding (PTB) that enables different phenotypes of RV hypertrophy with and without RV failure. We use a modified ligating clip applier to compress a titanium clip around the pulmonary trunk to a pre-set inner diameter. We use different clip diameters to induce different stages of disease progression from mild RV hypertrophy to decompensated RV failure.
RV hypertrophy develops consistently in rats subjected to the PTB procedure and depending on the diameter of the applied banding clip, we can accurately reproduce different disease severities ranging from compensated hypertrophy to severe decompensated RV failure with extra-cardiac manifestations.
The presented PTB model is a valid and robust model of pressure overload induced RV hypertrophy and failure that has several advantages to other banding models including high reproducibility and the possibility of inducing severe and decompensated RV failure.

We present a surgical method to induce right ventricular hypertrophy and failure in rats.

Right ventricular (RV) failure induced by sustained pressure overload is a major contributor to morbidity and mortality in several cardiopulmonary ...

Isometric Contractility Measurement of the Mouse Mesenteric Artery Using Wire Myography

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and drugs. It is widely used in many studies on the physiological functions of vascular smooth muscle, the pathogenesis of vascular diseases such as hypertension, and the development of smooth muscle relaxant drugs. The mouse is a widely used model animal with a large pool of disease models and genetically modified strains. We introduced this method to measure the isometric contraction of mouse mesenteric artery in detail. A 1.4-mm segment of mouse mesenteric resistance artery was isolated and mounted on a myograph chamber by passing two steel wires through its lumen. After equilibration and normalization steps, the vessel segment was potentiated by a high-K+ solution twice prior to the contraction assay. As an example of the application of this method in drug development, we measured the relaxant effect of a novel natural substance, neoliensinine, isolated from a Chinese herb, embryos of the lotus seed (Nelumbo nucifera Gaertn.) on mouse mesenteric arteries. The vessel segments mounted on the myograph chamber were stimulated with a high-K+ solution. When the force tension reached a stable sustained phase, cumulative doses of neoliensinine were added to the chamber. We found that neoliensinine had a dose-dependent relaxant effect on smooth muscle contraction, thus suggesting that it bears potential activity against hypertension. In addition, as the vessel segment can survive at least 4 hours after mounting and maintain contractility induced by the high-K+ solution for many times, we suggest that the wire myograph system may be used for the time-consuming process of drug screening.

The wire myograph technique is used to investigate vascular smooth muscle functions and screen new drugs. We report a detailed protocol for measuring the isometric contractility of the mouse mesenteric artery and for screening new relaxants of vascular smooth muscle.

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and ...

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

The Ross operation for aortic valve disease has regained new interest due to its outstanding long-term results. Nonetheless, when employed as freestanding root replacement, the possible dilation of the pulmonary autograft and subsequent aortic regurgitation is described. Several animal models have been proposed. However, these are usually limited to ex-vivo models or in-vivo experiments with relatively expensive large animal models. In this study, we sought to establish a rodent model of pulmonary artery graft (PAG) implantation in a systemic position. A total of 39 adult Lewis rats were included. Immediately after euthanasia, the pulmonary root was harvested from a donor animal (n=17). Syngeneic recipient (n=17) and sham-operated (n=5) rats were sedated and ventilated. In the recipient group, the PAG was implanted with an end-to-end anastomosis in infra-renal abdominal aortic position. Sham-operated rats underwent only transection and re-anastomosis of the aorta. Animals were followed with serial ultrasound studies for two months and post-mortem histological analysis. The median PAG diameter in the native position was 3.20 mm (IQR=3.18-3.23). At follow-up, the median diameter of the PAG was 4.03 mm (IQR=3.74-4.13) at 1 week, 4.07 mm (IQR=3.80-4.28) at 1 month, and 4.27 mm (IQR=3.90-4.35) at 2 months (p&lt;0.01). Peak systolic velocity was 220.07 mm/s (IQR=210.43-246.41) at 1 week, 430.88 mm/s (IQR=375.28-495.56) at 1 month, and 373.68 mm/s (IQR=305.78-429.81) at 2 months (p=0.02) and did not differ from the sham-operated group at the end of the experiment (p=0.5). Histological analysis did not show any sign of endothelial thrombosis. This study showed that rodent models may allow for the evaluation of the long-term adaptation of the pulmonary root to a high-pressure system. A systemically placed syngeneic PAG implantation represents a simple and feasible platform for the development and evaluation of novel surgical techniques and drug therapies to further improve the outcomes of the Ross operation.

We demonstrate how to establish a murine model of pulmonary root implantation into the descending aorta to simulate the Ross procedure. This model enables the medium/long-term evaluation of pulmonary autograft remodeling in a systemic position, representing the basis of developing therapeutic strategies to promote its adaptation.

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