Hollowed John J, Colbert Caroline M, Currier Jesse W, Nguyen Kim-Lien
Division of Cardiology, David Geffen School of Medicine, University of California Los Angeles; VA Greater Los Angeles Healthcare System, U.S. Department of Veterans Affairs.
Physics and Biology in Medicine Graduate Program, University of California Los Angeles; Diagnostic Cardiovascular Imaging Laboratory, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles.
J Vis Exp. 2020 Feb 18(156). doi: 10.3791/60729.
Minimally invasive methods for creating models of focal coronary narrowing in large animals are challenging. Rapid prototyping using three-dimensionally (3D) printed coronary implants can be employed to percutaneously create a focal coronary stenosis. However, reliable delivery of the implants can be difficult without the use of ancillary equipment. We describe the use of a mother-and-child coronary guide catheter for stabilization of the implant and for effective delivery of the 3D printed implant to any desired location along the length of the coronary vessel. The focal coronary narrowing was confirmed under coronary cineangiography and the functional significance of the coronary stenosis was assessed using gadolinium-enhanced first-pass cardiac perfusion MRI. We showed that reliable delivery of 3D printed coronary implants in swine models (n = 11) of ischemic heart disease can be achieved through repurposing mother-and-child coronary guide catheters. Our technique simplifies the percutaneous delivery of coronary implants to create closed-chest swine models of focal coronary artery stenosis and can be performed expeditiously, with a low procedural failure rate.
在大型动物中创建局灶性冠状动脉狭窄模型的微创方法具有挑战性。使用三维（3D）打印的冠状动脉植入物进行快速成型可用于经皮创建局灶性冠状动脉狭窄。然而，在不使用辅助设备的情况下，可靠地输送植入物可能很困难。我们描述了使用子母冠状动脉引导导管来稳定植入物，并将3D打印的植入物有效地输送到冠状动脉血管长度上的任何所需位置。在冠状动脉血管造影下确认局灶性冠状动脉狭窄，并使用钆增强首次通过心脏灌注MRI评估冠状动脉狭窄的功能意义。我们表明，通过重新利用子母冠状动脉引导导管，可以在缺血性心脏病猪模型（n = 11）中实现3D打印冠状动脉植入物的可靠输送。我们的技术简化了冠状动脉植入物的经皮输送，以创建局灶性冠状动脉狭窄的闭胸猪模型，并且可以快速进行，手术失败率低。
