Cadaveric Research: Informing Current Heart Surgery Techniques

Abstract

Cadavers have long been used in the anatomy lab as teaching tools however, they can also provide valuable research that addresses common surgical problems. Aortic root enlargement (ARE) procedures are employed to facilitate the implantation of larger valve prostheses however, published evidence remains largely anecdotal with respect to the specific increases achievable with these techniques. We sought to design a study using a cadaveric model that will allow for a controlled experiment to evaluate the efficacy of commonly employed ARE techniques. We harvested 20 adult hearts and stratified them into four groups based on aortic annular diameter. Each heart underwent a bileaflet mechanical valve implantation following four ARE techniques with the appropriate reversals between procedures. Annular diameters and implanted prosthesis sizes were recorded following each enlargement technique. We performed all four techniques on each heart with little disruption to the remaining aortic root tissue. In light of the study design, each heart served as its own control. We were also able to provide data as to the increases in implanted prosthesis size achieved with the four ARE techniques. Despite the limitations, cadaveric specimens can play a key role in cardiac surgical research. They provide important data for preoperative planning and allow for experimental research without patient risk.Grant Funding Source : Queen Elizabeth II Graduate Scholarship in Science and Technology