Multimodal imaging employed during extraction of pacing or defibrillator leads from perfusion-fixed human hearts

Holm, Mikayle A.; Vatterott, Pierce J.; Eggen, Michael D.; Iaizzo, Paul A.

doi:10.1016/j.hrcr.2020.08.025

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…For two and a half decades, the University of Minnesota's Visible Heart® Laboratories has incorporated multimodal imaging of these functioning hearts sustained with a clear perfusate. By using organ donor tissues acquired via an organ procurement organization, LifeSource, and performing evaluations and experiments on these specimens under replicated physiological conditions, our research team has been able to refine, reduce, and occasionally replace the use of animals for such cardiac research (Bateman et al, 2020 ; Holm et al, 2020 ; Iles et al, 2020 ; Mattson et al, 2019 ; Zhingre Sanchez et al, 2019 ); which has been critical for both cardiac device development and physician training. In the present study, we described the development and utilization of a pre‐clinical Visible Kidney™ apparatus for the same aforementioned purposes.…”

Section: Introductionmentioning

confidence: 99%

Preclinical research performed on reanimated/perfused swine kidneys: The Visible Kidney™ methodologies

Valenzuela

Schinstock

Kohnle

et al. 2023

Physiological Reports

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Preclinical research remains the essential platform in the development and optimization of medical therapies and advancements in translational medicines. However, specifically to animal research, federal laws, and institutional policies require investigators to apply the principles of the 3R's (replacement, reduction, and refinement). The concept of benchtop models utilizing isolated organs, in which multiple variables can be controlled to recreate human function, has been innovative advancements in preclinical research models that adhere to these principles. More specifically, isolated perfused kidney (IPK) models have been invaluable preclinical tools that have led to numerous advancements over the decades, including understanding renal physiology, pharmacologic therapies, and improvements in renal transplantation. However, pre‐existing IPK models are not without their own limitations, leaving areas for improvement. An isolated perfused kidney apparatus was designed to best recreate human use conditions as a preclinical tool. Porcine renal blocks were chosen over the more commonly used rodent models, due to their greater similarities to human anatomies. Sixteen porcine kidney pairs obtained en bloc were extracted and placed onto an apparatus where aortic flows, pressures, and overall systemic temperatures were controlled. Organ viability was assessed in 10 renal blocks (n = 8 fresh and n = 2 previously frozen specimens) via both urinary flows and compositions at timepoints up to 180 min. Multimodality imaging, which included fluoroscopy, ultrasound, optical coherence tomography (OCT), and video scopes, was also employed to capture internal and external images to determine renal artery orientations and dimensions. Anatomical measurements and viability assessments of porcine renal blocks were successfully achieved in our perfusion model. Renal main artery diameters averaged smaller in our sample size than in human anatomy while also having more superior takeoff angles. Yet, the average lengths of each main segment were comparable to human anatomy: 32.09 ± 7.97 mm and 42.23 ± 7.33 mm in the left and right renal main artery, respectively. Urine production and urine composition of the fresh renal blocks, when compared to the frozen blocks and baseline perfusate, showed kidney viabilities of up to 3 h via excretion and retention of various metabolites. In this paper, we described a protocol for an isolated perfused kidney apparatus using large mammalian renal blocks. We believe this protocol to be an improvement from similar pre‐existing models in better representing human physiologic function while allowing for multimodal imaging. The resulting Visible Kidney™ preclinical model, which has shown viability after isolation and reperfusion, can be a fast and reliable tool for the development of medical devices while also reducing the unnecessary use of animals for research.

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Section: Introductionmentioning

confidence: 99%

Preclinical research performed on reanimated/perfused swine kidneys: The Visible Kidney™ methodologies

Valenzuela

Schinstock

Kohnle

et al. 2023

Physiological Reports

Self Cite

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“…For over 25 years, the Visible Heart ® Laboratories have been dedicated to translational research and advancements in cardiac research, devices, and education [ 6 , 7 ]. We routinely perform PCI procedures, including many bifurcations, within reanimated large mammalian hearts [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Post-procedure micro-CT analyses of coronary artery stenting in left main vessels of reanimated and perfusion-fixed human hearts

Valenzuela

Iaizzo

2023

BioMed Eng OnLine

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Background Percutaneous coronary interventions (PCIs) within left main coronary arteries are high-risk procedures that require optimization of interactions between stent(s) and diseased vessels. Optical Coherence Tomography (OCT) is a widely accepted tool that enhances physicians’ ability to assess proper stent appositions during clinical procedures. The primary aim of this study was to develop complementary post-procedure imaging methodologies to better assess and interpret outcomes of left main PCI procedures, utilizing both reanimated and perfusion-fixed human hearts. Methods PCIs were performed while obtaining OCT scans within the left main anatomies of six human hearts. Subsequently, each heart was scanned with a micro-CT scanner with optimized parameters to achieve resolutions up to 20 µm. Scans were reconstructed and imported into a DICOM segmentation software to generate computational models of implanted stents and associated coronary vessels. 2D images from OCT that were obtained during PCIs were compared to the 3D models generated from micro-CT reconstructions. In addition, the 3D models were utilized to create virtual reality scenes and enlarged 3D prints for development of “mixed reality” tools relative to bifurcation stenting within human left main coronary arteries. Results We developed reproducible methodologies for post-implant analyses of coronary artery stenting procedures. In addition, we generated high-resolution 3D computational models, with ~ 20-micron resolutions, of PCIs performed within reanimated and perfusion-fixed heart specimens. Conclusions Generated computational models of left main PCIs performed in isolated human hearts can be used to obtain detailed measurements that provide further clinical insights on procedural outcomes. The 3D models from these procedures are useful for generating virtual reality scenes and 3D prints for physician training and education.

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Hycka

et al. 2023

Cirugía Cardiovascular

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Multimodal imaging employed during extraction of pacing or defibrillator leads from perfusion-fixed human hearts

Cited by 3 publications

References 5 publications

Preclinical research performed on reanimated/perfused swine kidneys: The Visible Kidney™ methodologies

Preclinical research performed on reanimated/perfused swine kidneys: The Visible Kidney™ methodologies

Post-procedure micro-CT analyses of coronary artery stenting in left main vessels of reanimated and perfusion-fixed human hearts

¿Electrodo extravascular o adherencias endovasculares?

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