Abstract
BackgroundGiven the growing population of cardiac surgery patients with impaired preoperative cardiac function and rapidly expanding surgical techniques, continued efforts to improve myocardial protection strategies are warranted. Prior research is mostly limited to either large animal models or ex vivo preparations. We developed a new in vivo survival model that combines administration of antegrade cardioplegia with endoaortic crossclamping during cardiopulmonary bypass (CPB) in the rat.MethodsSprague-Dawley rats were cannulated for CPB (n = 10). With ultrasound guidance, a 3.5 mm balloon angioplasty catheter was positioned via the right common carotid artery with its tip proximal to the aortic valve. To initiate cardioplegic arrest, the balloon was inflated and cardioplegia solution injected. After 30 min of cardioplegic arrest, the balloon was deflated, ventilation resumed, and rats were weaned from CPB and recovered. To rule out any evidence of cerebral ischemia due to right carotid artery ligation, animals were neurologically tested on postoperative day 14, and their brains histologically assessed.ResultsThirty minutes of cardioplegic arrest was successfully established in all animals. Functional assessment revealed no neurologic deficits, and histology demonstrated no gross neuronal damage.ConclusionThis novel small animal CPB model with cardioplegic arrest allows for both the study of myocardial ischemia-reperfusion injury as well as new cardioprotective strategies. Major advantages of this model include its overall feasibility and cost effectiveness. In future experiments long-term echocardiographic outcomes as well as enzymatic, genetic, and histologic characterization of myocardial injury can be assessed. In the field of myocardial protection, rodent models will be an important avenue of research.
Highlights
Given the growing population of cardiac surgery patients with impaired preoperative cardiac function and rapidly expanding surgical techniques, continued efforts to improve myocardial protection strategies are warranted
Considerable progress has been made in surgical techniques and other perioperative management to allow for the majority of patients to undergo cardiac surgery without significant mortality, more than 25% of this surgical population may still experience substantial morbidity related to adverse cardiovascular events
Based on an existing beating-heart model of cardiopulmonary bypass (CPB) in the rat [18], we developed a novel in vivo survival model that allows administration of antegrade cardioplegia and endoaortic crossclamping
Summary
Given the growing population of cardiac surgery patients with impaired preoperative cardiac function and rapidly expanding surgical techniques, continued efforts to improve myocardial protection strategies are warranted. Additional research in a suitable rodent model with good survivability appears to be warranted Such a model would allow to further elucidate mechanisms of adverse myocardial outcomes following cardioplegic arrest and permits the characterization of genetic, proteomic, and histologic changes as well as long-term functional outcomes in response to injury and therapy. It might facilitate further research aiming to optimize current cardioprotective strategies in vivo and facilitate myocardial gene delivery studies [16,17]
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