Suitability of the porcine aortic model for transcatheter aortic root repair
Suitability of the porcine aortic model for transcatheter aortic root repair
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DOI：
10.1093/icvts/ivx381
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发表时间：
2018-06-01
影响因子：
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通讯作者：
Ferrari, Enrico
中科院分区：
文献类型：
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作者：
Wang, Changtian;Lachat, Mario;Ferrari, Enrico
目的：应用经导管技术治疗主动脉瓣疾病及其伴发的根部疾病，需要植入“复合移植物”。我们的目标是评估猪主动脉根部是否适合用于经导管根部修复测试。方法：将8个从实验外科中使用的家猪移植的猪心与人类心脏文献中的数据进行比较。测量的直径包括主动脉环、Valsalva窦、冠状静脉口、窦管交界处、升主动脉、无名动脉和主动脉弓。测量距离为：冠状静脉口至相应环底、无名动脉至相应环底、弓小曲至相应环底。结果：猪平均体重89±5.4 kg。平均主动脉环直径20±1.2 mm(人：23.0±-2.5 mm)，Valsalva窦直径20.5±/-0.5 mm(人：31.4±-3.4 mm)，窦管连接直径20±0.9 mm(人：27.2±-3.0 mm)。平均升主动脉直径为19±0.7 mm(人：29.3±-4 mm)，无名动脉直径为8.5±/-0.7 mm，主动脉弓直径为15±0.7 mm，冠状静脉口直径为5+/-0.5 mm(左)和4.7±0.5 mm(右)(人：4.8+/-0.5 mm和3.7+/-0.9 mm)。左、右冠脉开口至相应环的距离分别为8±1.5 mm和14±2.4 mm(人：14.7±-1.3 mm；15.4±-1.7 mm)。无名动脉至左、右冠脉环底的距离分别为44±4.3 mm和41±4 mm(人：80±17 mm)。从小弓曲率到瓣环的距离为35+/-4.9 mm。结论：猪心可作为设计和测试基于导管的主动脉根部复合成形术的新装置的实验模型，但在使用尺寸定制的装置时需谨慎，这些装置必须与较小的猪根相适应。
OBJECTIVES: To treat aortic valve disease and concomitant root disease with transcatheter techniques, 'composite graft' implants are required. Our goal was to assess the suitability of the porcine aortic root for transcatheter root repair tests.METHODS: Eight pig hearts explanted from domestic pigs used in experimental surgery were compared to data from the literature on human hearts. The measured diameters included those of the annulus, sinuses of Valsalva, coronary ostia, sinotubular junction, ascending aorta, innominate artery and aortic arch. The measured distances were from the coronary ostia to the nadir of the corresponding annulus; from the innominate artery to the nadir of the corresponding annulus; from the small curvature of the arch to the nadir of the corresponding annulus.RESULTS: The mean weight of the pigs was 89 +/- 5.4 kg. The mean aortic annulus diameter was 20 +/- 1.2 mm (human: 23.0 +/- 2.5 mm), the sinus of Valsalva diameter was 20.5 +/- 0.5 mm (human: 31.4 +/- 3.4 mm) and the sinotubular junction diameter was 20 +/- 0.9 mm (human: 27.2 +/- 3.0 mm). The diameter of the mean ascending aorta was 19 +/- 0.7 mm (human: 29.3 +/- 4 mm); the diameter of the innominate artery was 8.5 +/- 0.7 mm, that of the aortic arch was 15 +/- 0.7 mm and that of the coronary ostia was 5 +/- 0.5 mm (left) and 4.7 +/- 0.5 mm (right) (human: 4.8 +/- 0.5 mm and 3.7 +/- 0.9 mm). The distances from the left and right coronary orifices to the corresponding annuli were 8 +/- 1.5 mm and 14 +/- 2.4 mm, respectively (human: 14.7 +/- 1.3 mm; 15.4 +/- 1.7 mm). The distances from the innominate artery to the nadirs of the left and right coronary annuli were 44 +/- 4.3 mm and 41 +/- 4 mm (human: 80 +/- 17 mm). The distance from the curvature of the small arch to the annulus was 35 +/- 4.9 mm.CONCLUSIONS: The porcine heart can be used as an experimental model to design and test new devices for catheter-based composite re-pair of the aortic root Nevertheless, caution is required in using devices with tailored dimensions that must be adapted to the smaller pig's root.