From the Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Surgery.
ASAIO J. 2021 Jan 1;67(1):e44-e48. doi: 10.1097/MAT.0000000000001197.
Pulmonary hypertension (PH) is a progressive disease that leads to cardiopulmonary dysfunction and right heart failure from pressure and volume overloading of the right ventricle (RV). Mechanical cardiopulmonary support has theoretical promise as a bridge to organ transplant or destination therapy for these patients. Solving the challenges of mechanical cardiopulmonary support for PH and RV failure requires its testing in a physiologically relevant animal model. Previous PH models in large animals have used pulmonary bead embolization, which elicits unpredictable inflammatory responses and has a high mortality rate. We describe a step-by-step guide for inducing pulmonary hypertension and right ventricular hypertrophy (PH-RVH) in sheep by left pulmonary artery (LPA) ligation combined with progressive main pulmonary artery (MPA) banding. This approach provides a controlled method to regulate RV afterload as tolerated by the animal to achieve PH-RVH, while reducing acute mortality. This animal model can facilitate evaluation of mechanical support devices for PH and RV failure.
肺动脉高压(PH)是一种进行性疾病,可导致右心室(RV)压力和容量超负荷引起的心肺功能障碍和右心衰竭。机械心肺支持作为这些患者的器官移植或终末期治疗的桥梁具有理论上的前景。要解决机械心肺支持治疗 PH 和 RV 衰竭的挑战,需要在生理相关的动物模型中进行测试。以前在大型动物中使用肺动脉珠栓塞来建立 PH 模型,这种方法会引起不可预测的炎症反应,且死亡率较高。我们描述了一种通过左肺动脉(LPA)结扎联合进行性主肺动脉(MPA)缩窄在绵羊中诱导肺动脉高压和右心室肥厚(PH-RVH)的分步指南。这种方法提供了一种可控的方法,可根据动物的耐受程度调节 RV 后负荷,从而实现 PH-RVH,同时降低急性死亡率。这种动物模型可以促进对 PH 和 RV 衰竭的机械支持设备的评估。