Xia Qingping, Cao Yong, Li Jialuan, Jiang Jie, Lu Xuan, Deng Li
Department of Science and Education, Gaozhou People's Hospital, Gaozhou, Guangdong, China.
Department of Cardiovascular Surgery, The People's Hospital of Gaozhou, Gaozhou, Guangdong, China.
Front Cardiovasc Med. 2025 Jan 8;11:1427653. doi: 10.3389/fcvm.2024.1427653. eCollection 2024.
The objective of this study was to improve long-term postoperative survival in a porcine cardiac valve surgery model by utilizing cardiopulmonary bypass (CPB) via left thoracotomy. The study aimed to share refined techniques and insights accumulated over years at a single-center animal clinical trial facility.
A total of 196 Chinese Large White pigs weighing between 60 and 75 kg were used in the study. All animals underwent cardiac valve surgeries via left thoracotomy with CPB. Surgical techniques included mitral valve replacement, mitral valve repair, aortic valve replacement, OZAKI procedure, ascending aorta replacement, and left ventricular assist device implantation. Anesthesia and CPB protocols were optimized to minimize stress and complications. Postoperative care was standardized to enhance recovery and survival.
All 196 pigs survived the surgical procedures, with no deaths reported. The mean surgical duration was 168.55 ± 38.75 min, CPB time was 114.89 ± 32.11 min, and aortic cross-clamp time was 76.75 ± 21.33 min. Automatic heart resumption occurred in 63.8% of pigs, while the remainder required electrical defibrillation or cardiac massage. The postoperative mechanical ventilation time was 2.44 ± 0.58 min, and the average drainage volume at 2 h postoperatively was 27.50 ± 9.70 ml. There were no cases of postoperative hemorrhage complications or blood transfusions, and surgical site infections occurred in only 1.5% of pigs.
The surgical approach utilizing left thoracotomy with CPB has proven effective in significantly enhancing long-term survival rates in porcine heart surgeries. The refined techniques and standardized operational procedures described in this study offer valuable insights for researchers aiming to improve the success of porcine heart valve surgical models. However, due to differences in animal anatomy, the applicability of this surgical approach to other animal models still requires further exploration.
本研究的目的是通过左胸开胸体外循环（CPB）改善猪心脏瓣膜手术模型的术后长期生存率。该研究旨在分享在单中心动物临床试验机构多年积累的精细技术和见解。
本研究共使用了196头体重在60至75千克之间的中国大白猪。所有动物均通过左胸开胸并采用CPB进行心脏瓣膜手术。手术技术包括二尖瓣置换、二尖瓣修复、主动脉瓣置换、小崎手术、升主动脉置换和左心室辅助装置植入。优化了麻醉和CPB方案以尽量减少应激和并发症。术后护理标准化以促进恢复和提高生存率。
196头猪均成功完成手术，无死亡报告。平均手术时间为168.55±38.75分钟，CPB时间为114.89±32.11分钟，主动脉阻断时间为76.75±21.33分钟。63.8%的猪自动恢复心跳，其余猪需要电除颤或心脏按摩。术后机械通气时间为2.44±0.58分钟，术后2小时平均引流量为27.50±9.70毫升。无术后出血并发症或输血情况，仅1.5%的猪发生手术部位感染。
采用左胸开胸并结合CPB的手术方法已被证明可有效显著提高猪心脏手术的长期生存率。本研究中描述的精细技术和标准化操作程序为旨在提高猪心脏瓣膜手术模型成功率的研究人员提供了有价值的见解。然而，由于动物解剖结构的差异，这种手术方法在其他动物模型中的适用性仍需进一步探索。
