Establishing Background Pathologic Changes of Valve Replacement Surgery in Sheep,Cardiovascular Engineering and Technology

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Establishing Background Pathologic Changes of Valve Replacement Surgery in Sheep
Cardiovascular Engineering and Technology ( IF 1.8 ) Pub Date : 2021-07-14 , DOI: 10.1007/s13239-021-00563-6
Jill T Schappa Faustich ₁ , John P Carney ₁ , Matthew T Lahti ₁ , Benjamin L Zhang ₁ , Richard W Bianco ₁

Affiliation

Purpose

Sheep are the standard preclinical model for assessing safety of novel replacement heart valves, yet the anatomic and pathologic effects of invasive surgery, including those involving cardiopulmonary bypass (CPB), are unknown. Thus, we aimed to determine the gross, hematologic and biochemical effects of sham mitral and aortic replacement valve procedures in sheep to establish a useful control for evaluation of novel replacement valves.

Methods

Six control sheep were examined without any surgical intervention. Six sham mitral valve replacements (MVR) and six sham aortic valve replacements (AVR) were performed on 12 sheep. Complete blood counts and serum biochemistry were performed throughout the study. Sheep were sacrificed with a necropsy performed at 90 days.

Results

Renal infarcts (RIs) were the most frequently observed lesion, averaging 4.7 in control sheep, 2.5 with MVR and 5.8 with AVR. The number of infarcts strongly correlated with total estimated area of infarcted kidney (r = .84, p < .01). Additional cardiac interventions were significantly correlated with increased numbers of RIs (r = .85, p < .01). There was no correlation between number of RIs and time on CPB, or between AVR and MVR procedures.

Conclusion

The sheep model for AVR and MVR requires invasive surgery and CPB, which are associated with background anatomic and pathologic changes, especially in cases with additional surgical cardiac interventions. These findings serve as a critical control for future evaluation and development of novel replacement valves in order to distinguish device-related safety issues from expected outcomes of the surgical procedure and normal background changes in sheep.

中文翻译：

建立绵羊瓣膜置换手术的背景病理变化

目的

绵羊是评估新型置换心脏瓣膜安全性的标准临床前模型，但侵入性手术（包括涉及体外循环 (CPB) 的手术）的解剖学和病理学影响尚不清楚。因此，我们旨在确定假二尖瓣和主动脉瓣置换术对绵羊的总体、血液学和生化影响，从而为评估新型置换瓣膜建立有用的控制。

方法

在没有任何手术干预的情况下检查了六只对照绵羊。对 12 只绵羊进行了 6 次假二尖瓣置换术 (MVR) 和 6 次假主动脉瓣置换术 (AVR)。在整个研究过程中进行全血细胞计数和血清生化。在 90 天时进行尸检，将绵羊处死。

结果

肾梗塞 (RIs) 是最常观察到的病变，对照绵羊平均为 4.7，MVR 平均为 2.5，AVR 平均为 5.8。梗塞的数量与梗塞肾脏的总估计面积密切相关（r = .84，p < .01）。额外的心脏干预与增加的 RI 数量显着相关 ( r = .85, p < .01)。RI 的数量与 CPB 的时间或 AVR 和 MVR 程序之间没有相关性。