Bianco R W, St Cyr J A, Schneider J R, Rasmussen T M, Clack R M, Shim H S, Sandstad J, Rysavy J, Foker J E
J Surg Res. 1986 Aug;41(2):134-40. doi: 10.1016/0022-4804(86)90018-1.
The evaluation of mechanical prosthetic heart valves would be aided by a more satisfactory animal model. For acute assessment, a variety of animals have been used, but for chronic studies, only larger animals (pigs, calves, baboons) have been employed, creating an expensive model with laboratory management difficulties. Previously, the use of dogs for chronic evaluation has been unsatisfactory because of the frequent occurrence of early sepsis and valve-related thrombotic deaths. We have modified our existing acute dog protocol to produce a successful chronic model. Our model employs perioperative systemic antibiotics, short cardiopulmonary bypass period (range 35-60 min), a minimum of perioperative intravenous lines, postoperative anticoagulation therapy, and strict postoperative antiseptic technique for blood sampling. To evaluate this model, 11 consecutive mongrel dogs underwent mitral valve replacement with either a standard Dacron sewing skirt or a newly devised carbon-coated Teflon sewing skirt No. 23 mm Bjork-Shiley Convexo Concave (CC) prosthetic valve. Nine animals (82%) survived and were evaluated after a predetermined observation interval of either 3 or 6 months for valve function, pannus formation, and possible carbon particle migration. At sacrifice, all animals had good hemodynamics and valve function, minimal pannus formation and no carbon washout. Consequently, this model provides a relatively inexpensive, reproducible method of chronic in vivo evaluation of prosthetic valve modifications.
更理想的动物模型将有助于对机械人工心脏瓣膜进行评估。在急性评估中,已使用了多种动物,但在慢性研究中,仅使用了较大型的动物(猪、小牛、狒狒),这使得模型成本高昂且实验室管理困难。此前,由于早期败血症和瓣膜相关血栓形成死亡频繁发生,使用狗进行慢性评估并不理想。我们对现有的急性狗实验方案进行了改进,以建立一个成功的慢性模型。我们的模型采用围手术期全身抗生素、短时间体外循环(35 - 60分钟)、最少的围手术期静脉置管、术后抗凝治疗以及严格的术后血液采样防腐技术。为评估该模型,11只连续的杂种狗接受了二尖瓣置换,使用标准的涤纶缝合裙边或新设计的23毫米带碳涂层聚四氟乙烯缝合裙边的Bjork - Shiley凸凹(CC)人工瓣膜。9只动物(82%)存活,并在3个月或6个月的预定观察期后对瓣膜功能、血管翳形成和可能的碳颗粒迁移进行评估。处死时,所有动物的血流动力学和瓣膜功能良好,血管翳形成最少且无碳洗脱。因此,该模型为人工瓣膜改良的慢性体内评估提供了一种相对廉价、可重复的方法。