Cui J S, Zhuang S J, Zhang J, Mei Z J, Jing Z P, Liao M F
Department of Vascular Surgery, Huadong Hospital, The Fudan University, Shanghai, China.
Eur J Vasc Endovasc Surg. 2009 Nov;38(5):603-7. doi: 10.1016/j.ejvs.2009.07.005. Epub 2009 Aug 5.
To establish an animal model of Stanford type B aortic dissection using a two-end intimal flap suturing.
Twelve adult mongrel dogs of either sex were studied and followed up, at intervals, up to 1 year.
A lateral clamp was placed on the proximal descending aorta after general anaesthesia and left thoracotomy. Half the circumference of the aorta, including the media and adventitia, was cut open transversely, leaving the intima intact. The aortic wall was separated inferiorly. The intima was transversely cut and both ends of the distal intimal flap were sutured to the adjacent aorta. To close, the distal adventitia and media were sutured to the proximal aorta. Before thoracic cavity closure, digital subtraction angiography (DSA) and colour Doppler ultrasound were performed.
Formation and distal extension was observed immediately after removal of the partial aortic clamp in 11 dogs. True and false lumens were seen in eight dogs; the false lumen was larger than the true lumen. Sacrifice at set intervals, 7 days to 12 months after surgery, showed a typical dissection tear, intima, septum, adventitia, thrombi and distal dissection blind pocket.
This model of aortic dissection using the two-end aortic intimal flap suturing method is similar to human Stanford type B aortic dissection.
采用两端内膜瓣缝合术建立B型主动脉夹层动物模型。
对12只成年杂种犬(雌雄不限)进行研究,并随访长达1年,期间定期进行检查。
全身麻醉并左胸开胸后,在降主动脉近端放置侧钳。将主动脉包括中膜和外膜的半周横向切开,保留内膜完整。将主动脉壁向下分离。横向切开内膜,将远端内膜瓣的两端缝合至相邻的主动脉。然后,将远端外膜和中膜缝合至近端主动脉以完成闭合。在关闭胸腔前,进行数字减影血管造影(DSA)和彩色多普勒超声检查。
11只犬在移除部分主动脉钳后立即观察到夹层形成及向远端扩展。8只犬可见真腔和假腔;假腔大于真腔。在术后7天至12个月的设定时间间隔处处死动物,可见典型的夹层撕裂、内膜、隔膜、外膜、血栓及远端夹层盲袋。
这种采用两端主动脉内膜瓣缝合方法的主动脉夹层模型与人类B型主动脉夹层相似。