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dc.contributor.authorPasrija, Chetan
dc.contributor.authorQuinn, Rachael W
dc.contributor.authorAlkhatib, Hani
dc.contributor.authorTran, Douglas
dc.contributor.authorBernstein, Daniel
dc.contributor.authorRice, MaryJoe
dc.contributor.authorKotloff, Ethan
dc.contributor.authorMorales, David
dc.contributor.authorD'Ambra, Michael N
dc.contributor.authorVesely, Mark R
dc.contributor.authorGammie, James S
dc.date.accessioned2021-01-20T21:45:26Z
dc.date.available2021-01-20T21:45:26Z
dc.date.issued2020-06-15
dc.identifier.urihttp://hdl.handle.net/10713/14380
dc.description.abstractBackground: Durability of mitral valve repair for ischemic mitral regurgitation (IMR) remains poor. We established a swine model of chronic IMR, and describe the methods and lessons learned from this model. Methods: Thirty-five swine underwent percutaneous myocardial infarction with ethanol ablation of the circumflex or obtuse marginal (OM) arteries. Swine were followed with routine echocardiography for the development of severe IMR. Once severe IMR was established, swine underwent mitral valve operations on cardiopulmonary bypass. After operation, swine were survived up to 7 weeks. Angiographic and echocardiographic features of swine who developed severe IMR (IMR swine) and those who did not (non-IMR swine) were compared. Results: The median number of OM arteries was 3, with 2 OM arteries infarcted. Acute survival after the myocardial infarction was 74% (26 of 35) with 3 (9%) early, postoperative deaths. Among the 23 swine with follow-up to determine IMR status, 14 of 23 (61%) developed significant IMR. Among IMR pigs, left ventricular (LV) ejection fraction decreased from 65% pre-myocardial infarction to 45% pre-mitral valve intervention (P < .001). Among non-IMR swine, LV ejection fraction decreased nonsignificantly from baseline (60%) to latest follow-up (55%) (P = .443). LV end-diastolic dimension (P = .039), wall motion score (P = .027), global circumferential strain (P = .014), and global longitudinal strain (P = .023) were significantly worse in IMR compared with non-IMR swine. Conclusions: A reproducible percutaneous model of severe IMR in swine is feasible with a guided anesthetic and perioperative approach. This model can serve as a platform to better understand the mechanism of IMR and subsequently to test novel repair techniques.en_US
dc.description.urihttps://doi.org/10.1016/j.athoracsur.2020.04.112en_US
dc.language.isoenen_US
dc.publisherElsevier Inc.en_US
dc.relation.ispartofAnnals of Thoracic Surgeryen_US
dc.rightsCopyright © 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.en_US
dc.subjectChronic Ischemic Mitral Regurgitationen_US
dc.subject.meshSwineen_US
dc.titleDevelopment of a Reproducible Swine Model of Chronic Ischemic Mitral Regurgitation: Lessons Learned.en_US
dc.typeArticleen_US
dc.typeOtheren_US
dc.identifier.doi10.1016/j.athoracsur.2020.04.112
dc.identifier.pmid32553769
dc.source.volume111
dc.source.issue1
dc.source.beginpage117
dc.source.endpage125
dc.source.countryNetherlands


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