Modelo experimental de insuficiencia mitral en modelo animal porcino

  1. Miguel Rodríguez-Santamarta 1
  2. Rodrigo Estévez-Loureiro 2
  3. Claudia Pérez Martínez 3
  4. José Antonio Rodríguez-Altónaga Martínez 3
  5. Marta Regueiro Purriños 3
  6. Carlos Cuellas Ramón 1
  7. María López Benito 1
  8. Tomás Benito González 1
  9. David Alonso Rodríguez 1
  10. David Viñuela Baragaño 4
  11. Javier Gualis Cardona 5
  12. José Manuel Gonzalo Orden 4
  13. Carlos Minguito Carazo 1
  14. Elena Tundidor Sanz 1
  15. Samuel del Castillo García 1
  16. Armando Pérez de Prado 3
  17. Mario Castaño Ruiz 5
  18. Felipe Fernández Vázquez 3
  1. 1 Servicio de Cardiología, Hospital Universitario de León, León, España
  2. 2 Unidad de Cardiología Intervencionista, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España
  3. 3 Unidad de Investigación Consolidada de Castilla y León (UIC104), Fundación Investigación Sanitaria en León, Universidad de León, Hospital Universitario de León, León, España
  4. 4 Departamento de Veterinaria, Universidad de León, León, España
  5. 5 Departamento de Cirugía Cardiaca, Hospital Universitario de León, León, España
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Journal:
REC: Interventional Cardiology

ISSN: 2604-7276,  2604-7306

Year of publication: 2021

Volume: 3

Issue: 1

Pages: 8-14

Type: Article

DOI: 10.24875/RECIC.M20000122 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: REC: Interventional Cardiology

Abstract

Introduction and objectives: There is great interest in the development of devices for the percutaneous management of mitral regurgitation (MR). For this reason, having an experimental model that reproduces the conditions of the disease is of great importance. Our objective was to validate an experimental model of MR in a porcine model. Methods: For the model creation phase 3, 2-month-old 25 ± 3 kg large white pigs were used. An acute myocardial infarction was caused in the circumflex artery territory that hampered the perfusion of the posteromedial papillary muscle. Then, volume overload was induced in the animal by creating an arteriovenous shunt and connecting the aorta and the pulmonary artery using a Dacron tube. Echocardiography and magnetic resonance imaging were performed before the intervention and on week 8. Afterwards, the animal was euthanized to conduct the pathological study. Results: One out of the 3 pigs died during the intervention due to ventricular fibrillation. The remaining 2 pigs survived the procedure and were euthanized as scheduled on week 8. In both cases a transmural infarction occurred, 1 at lateral level and the other one at posteroinferior level with moderate secondary mitral regurgitation. Ventricular dimensions and volumes increased and the overall contractility was maintained despite segmental alterations. Conclusions: The experimental model of chronic MR based on the ischemic damage of the posteromedial papillary muscle associated with volume overload is feasible, safe and reproducible. Also, it can be very useful to test the safety and efficacy of future devices for the management of this condition.

Bibliographic References

  • 1. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017;38:2739-2791.
  • 2. Mirabel M, Iung B, Baron G, et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery?Eur Heart J. 2007;28:1358-1365.
  • 3. Borger MA, Alam A, Murphy PM, Doenst T, David TE. Chronic ischemic mitral regurgitation:repair, replace or rethink?Ann Thorac Surg. 2006;81:1153-1161.
  • 4. Jamieson WR, Edwards FH, Schwartz M, Bero JW, Clark RE, Grover FL. Risk stratification for cardiac valve replacement. National Cardiac Surgery. Ann Thorac Surg. 1999;67:943-951.
  • 5. Herrmann HC, Maisano F. Transcatheter therapy of mitral regurgitation. Circulation. 2014;130:1712-1722.
  • 6. Maisano F, Alfieri O, Banai S, et al. The future of transcatheter mitral valve interventions:competitive or complementary role of repair vs. replacement?Eur Heart J. 2015;36:1651-1659.
  • 7. Mauri L, Foster E, Glower DD, et al. 4-year results of a randomized controlled trial of percutaneous repair versus surgery for mitral regurgitation. J Am Coll Cardiol. 2013;62:317-328.
  • 8. Nickenig G, Estevez-Loureiro R, Franzen O, et al. Percutaneous Mitral Valve Edge-to-Edge Repair:In-Hospital Results and 1-Year Follow-Up of 628 Patients of the 2011-2012 Pilot European Sentinel Registry. J Am Coll Cardiol. 2014;64:875-84.
  • 9. Maisano F, Franzen O, Baldus S, et al. Percutaneous mitral valve interventions in the real world:early and 1-year results from the ACCESS-EU, a prospective, multicenter, nonrandomized post-approval study of the MitraClip therapy in Europe. J Am Coll Cardiol. 2013;62:1052-1061.
  • 10. Cui YC, Li K, Tian Y, et al. A pig model of ischemic mitral regurgitation induced by mitral chordae tendinae rupture and implantation of an ameroid constrictor. PloS One. 2014;9:e111689.
  • 11. Minakawa M, Robb JD, Morital M, et al. A model of ischemic mitral regurgitation in pigs with three-dimensional echocardiographic assessment. J Heart Valve Dis. 2014;23:713-720.
  • 12. Hamza O, Kiss A, Kramer AM, Tillmann KE, Podesser BK. Characterization of a novel percutaneous closed chest swine model of ischemic mitral regurgitation guided by contrast echocardiography. Eurointervention. 2019. pii:EIJ-D-19-00095.
  • 13. Aguero J, Galan-Arriola C, Fernandez-Jimenez R, et al. Atrial Infarction and Ischemic Mitral Regurgitation Contribute to post-MI Remodeling of the Left Atrium. J Am Coll Cardiol. 2017;70:2878-2889.
  • 14. Llaneras MR, Nance ML, Streicher JT, et al. Large animal model of ischemic mitral regurgitation. Ann Thorac Surg. 1994;57:432-439
  • 15. Pereda D, García-Lunar I, Sierra F, et al. Magnetic Resonance Characterization of Cardiac Adaptation and Myocardial Fibrosis in Pulmonary Hypertension Secondary to Systemic-To-Pulmonary Shunt. Circ Cardiovasc Imaging. 2016;9:e004566.
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