Intensive Care Unit, Hangzhou Red Cross Hospital (Zhejiang Traditional Chinese and Western Medicine Hospital), Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.
J Heart Lung Transplant. 2009 Oct;28(10):1102-6. doi: 10.1016/j.healun.2009.05.025.
The development of microsurgical techniques has facilitated the establishment of fully vascularized cardiac transplantation models in small mammals. Anastomotic stenosis and bleeding continue to hamper procedures and limit long-term graft survival. In this study we assess a novel technique to improve outcome after cardiac transplantation in mice.
Our novel technique of murine heterotopic cardiac transplantation consists of three critical steps: (i) a novel procedure for graft harvest; (ii) a modified method for recipient vessel preparation; and (iii) a novel suturing procedure for graft implantation. Importantly, a new knotless suturing technique for end-to-side vascular anastomosis was applied, which allows for adjustment of the anastomosis after transplantation, thus reducing the risk of anastomotic bleeding or stenosis.
The recipient survival rate based on this novel technique was between 90% and 98%, depending on physician expertise. Graft implantation time varied between 20 and 25 minutes after the initial 200 training cases. In comparing the standard knot microvascular suturing technique to the new knotless technique carried out by an experienced surgeon, the latter was found to be more efficient by significantly reducing the rate of anastomotic stenosis (0% vs 8% with knot, p < 0.001, n = 200) and anastomotic bleeding (2% vs 7% with knot, p < 0.05, n = 200).
This novel technique offers a rapid, easy and effective method for murine heterotopic cardiac transplantation.
显微外科技术的发展促进了小型哺乳动物全血管化心脏移植模型的建立。吻合口狭窄和出血仍然妨碍手术，限制了移植物的长期存活。在这项研究中，我们评估了一种改善小鼠心脏移植后结果的新方法。
我们的小鼠异位心脏移植的新技术包括三个关键步骤：（i）一种新的供体采集程序；（ii）一种改良的受体血管准备方法；和（iii）一种新的供体移植缝合程序。重要的是，应用了一种新的无结缝合技术进行端侧血管吻合，这允许在移植后调整吻合口，从而降低吻合口出血或狭窄的风险。
根据这一新技术，受者的存活率在 90%至 98%之间，这取决于医生的经验。供体植入时间在最初的 200 例训练病例后 20 至 25 分钟之间变化。将标准结微血管缝合技术与经验丰富的外科医生进行的新无结技术进行比较，后者通过显著降低吻合口狭窄的发生率（无结 0%，有结 8%，p<0.001，n=200）和吻合口出血的发生率（无结 2%，有结 7%，p<0.05，n=200），被证明更为有效。
这种新技术为小鼠异位心脏移植提供了一种快速、简单、有效的方法。
