Orthotopic Total Aortic Root Replacement Model in Adult Sheep

Rakow, Nancy; Nelson, Dale; Falkner, Phillip; Wahlberg, Phil; Grangaard, Robyn; Capps, Mark; Billstrom, Tina; Shecterle, Linda M.; Cyr, John A. St.

doi:10.1080/08941930601126322

Cited by 4 publications

(6 citation statements)

References 4 publications

(3 reference statements)

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“…In other similar studies, the internal temperature was lowered even further, to 28 °C6,10 or 25 °C. 18 We found that administering ice-cold cardioplegic solution and routinely applying ice-cold saline directly into the pericardium and left ventricle were cardioprotective. Cooling down the cardioplegic solution to 4 °C or using saline slush has also been described in literature.…”

Section: Discussionmentioning

confidence: 97%

“…19 Consequently, high on-table mortality rates, ranging from 9% to 33%, have been reported. 1,18,21,24 Furthermore, the incidence of mortality during the first 30 d after surgery, directly related to the surgical procedure, is often high, ranging from 17% to 50%. 1,2,16,18,21 Therefore, optimizing cardioprotective strategies during surgery would improve postoperative survival.…”

mentioning

confidence: 99%

“…1,18,21,24 Furthermore, the incidence of mortality during the first 30 d after surgery, directly related to the surgical procedure, is often high, ranging from 17% to 50%. 1,2,16,18,21 Therefore, optimizing cardioprotective strategies during surgery would improve postoperative survival. However, little is known about protective strategies in sheep.…”

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confidence: 99%

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Strategies to Improve Survival from Surgery for Heart Valve Implantation in Sheep

et al. 2021

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Sheep are a commonly used and validated model for cardiovascular research and, more specifically, for heart valve research.Implanting a heart valve on the arrested heart in sheep is complex and is often complicated by difficulties in restarting the heart, causing significant on-table mortality. Therefore, optimal cardioprotective management during heart valve implantation in sheep is essential. However, little is known about successful cardioprotective management techniques in sheep. This article reports our experience in the cardioprotective management of 20 female sheep that underwent surgical aortic valve replacement with a stented tissue-engineered heart valve prosthesis. During this series of experiments, we modified our cardioprotection protocol to improve survival. We emphasize the importance of total body hypothermia and external cooling of the heart. Furthermore, we recommend repeated cardioplegia administration at 20 min intervals during surgery, with the final dosage of cardioplegia given immediately before the de-clamping of the aorta. To reduce the number of defibrillator shocks during a state of ventricular fibrillation (VF), we have learned to restart the heart by reclamping the aorta, administeringcardioplegia until cardiac arrest, and de-clamping the aorta thereafter. Despite these encouraging results, more researchis needed to finalize a protocol for this procedure.

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

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Strategies to Improve Survival from Surgery for Heart Valve Implantation in Sheep

et al. 2021

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“…Sheep have long been established as an animal model in heart valve research for the preclinical safety assessment of prosthetic and bioprosthetic cardiac valves [1][2][3]. The cardiovascular system and blood coagulation profile of sheep is similar to humans and the aortic root allows for implantation and evaluation of cardiac devices using standard cardiopulmonary bypass and anesthetic protocols [1].…”

Section: Introductionmentioning

confidence: 99%

“…Stephen Q Garofolo 1 *, Christine Watson 2 , Richard W Bianco 1 and Nicholas A Robinson 1,2 1 Experimental Surgical Services, University of Minnesota Medical School, USA 2 University of Minnesota College of Veterinary Medicine, USA of leaflets, structural valvular dysfuction, paravalvular leaks, or other surgical complications leading to congestive heart failure and death. Early deaths unrelated to the valve or surgical procedure, such as environmental stress or natural disease are not common, and while precautionary steps in the husbandry and management of the animals are taken to prevent them, they do occur occasionally.…”

Section: Introductionmentioning

confidence: 99%

Cases of Sudden Death in a Sheep Model Implanted with Aortic Bioprostheses

2014

J Vet Sci Med

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Background: Sheep have long been established as an animal model in heart valve research for the preclinical safety assessment of prosthetic and bioprosthetic cardiac valves. Complications unrelated to the implant or surgical procedure are uncommon, but do represent a significant loss of data when they occur. Here we report the pre-term deaths of 3 sheep implanted with a bioprosthetic aortic valve. Aims:(1) To present potential physiological limitations of bioprosthetic aortic valves and the effect on the host animals' ability to compensate for environmental stressors and (2) consider these findings as they relate to the future long-term management of these animals during the in-life stage of studies. Methods:The early deaths of 3 sheep implanted with a novel bioprosthetic aortic valve were retrospectively analyzed including medical records, surgical records, pathology, and historical weather data.Results: Necropsy of all sheep revealed a stenotic left ventricular outflow tract and general findings consistent with acute congestive heart failure as a cause of death secondary to heat stress. Historical weather data identified high ambient temperatures, low wind speeds, and moderate humidity on the days the sheep died. Conclusion:The placement of bioprosthetic valve in the aortic position in sheep can result in significant compromise to the left side of the heart. It should be assumed that these sheep have a decreased cardiac reserve, limited ability to compensate in response to environmental stressors, and are at increased risk of adverse cardiac events including those possible during a heat wave. This should be considered when determining the appropriate post operative care of these animals.

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Dual Arterial Cannulation for Aortic Surgical Procedures in Adult Sheep

Kopcak

Barka²,

Rakow³

et al. 2010

Eur Surg Res

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Background/Aims: Preclinical site-specific placement of valvular prostheses is highly recommended to fully appreciate hemodynamics. An ovine model is commonly used for preclinical prosthetic mitral valve evaluation; however, the ideal animal model for prosthetic aortic valve evaluation has yet to be determined. Past studies have utilized adult sheep for prosthetic aortic valve replacement; however, an anatomically short length of the ascending aorta can present a surgical challenge during implantation. Due to this anatomically short length of the ascending aorta, we designed an arterial cannulation technique for cardiopulmonary bypass (CPB) to provide a more ideal operative setting. Methods: Dual arterial cannulation for CPB was used in adult Polypay sheep (n = 15) subjected to an aortic root/valve surgical procedure. Results: The arterial cannulation technique described in this paper was successful in performing aortic root/valve surgical procedures in adult sheep. All animals survived the operative procedure without complications. Postoperatively, all animals were alert, neurologically intact and assumed normal daily functions following extubation, which continued throughout their survival. Conclusions: The use of this arterial cannulation technique was safe, provided better visualization of the aortic root/valve area, less difficulty in performing the aortic root/valve surgical procedure, and less observed tissue tension while closing the aortotomy.

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Orthotopic Total Aortic Root Replacement Model in Adult Sheep

Cited by 4 publications

References 4 publications

Strategies to Improve Survival from Surgery for Heart Valve Implantation in Sheep

Strategies to Improve Survival from Surgery for Heart Valve Implantation in Sheep

Cases of Sudden Death in a Sheep Model Implanted with Aortic Bioprostheses

Dual Arterial Cannulation for Aortic Surgical Procedures in Adult Sheep

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