title: A size-matching heterotopic aortic valve implantation model in the rat.
abstract: BACKGROUND
  Structural failure of cardiac valve allografts may be related to technical factors such as size mismatch, resulting in early intimal proliferation and fibrosis or immunological reactions against the transplanted valves, featuring lymphocytic infiltration.
  
  
  OBJECTIVE
  To develop a heterotopic aortic valve implantation model in the rat to study the immunological factors leading to graft failure in the setting of a technical adaptation for size mismatch.
  
  
  METHODS
  Syngeneic (WAG-WAG or DA-DA) and allogeneic (WAG-BN or WAG-DA) rat strain combinations were used to study the effect of the allogeneic response on valve properties. An end-to-side anastomosis was made between the U-shaped aortic root graft and the recipient's abdominal aorta to resolve the problems of size matching.
  
  
  RESULTS
  No animals suffered from ischemic or neurological complications during the study period. One hundred percent survival and patency of the aortic grafts were achieved at the end of a 21-day observation period. In the syngeneic group 9 of 10 valves were still competent when assessed during retrograde injection. In contrast, 2 of 10 allogeneic valve grafts were competent on postoperative Day 21. Microscopic evaluation revealed no fibrosis or intimal thickening in the syngeneic valve grafts while the allogeneic valve grafts demonstrated rejection-like morphology.
  
  
  CONCLUSIONS
  The absence of fibrosis and intimal thickening in the syngeneic transplanted valve grafts indicates that this implantation model is not influenced by nonimmunological-based structural changes. Therefore, this new model enables us to study the association between donor-directed immune responses and allograft degeneration in a technically unbiased manner.
authors.affiliation: Department of Thoracic Surgery, University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands. OEI@INW1.AZR.NL
authors.forename: F B
authors.initials: FB
authors.lastname: Oei
authors.forename: M J
authors.initials: MJ
authors.lastname: Welters
authors.forename: F
authors.initials: F
authors.lastname: Bonthuis
authors.forename: L M
authors.initials: LM
authors.lastname: Vaessen
authors.forename: R L
authors.initials: RL
authors.lastname: Marquet
authors.forename: P E
authors.initials: PE
authors.lastname: Zondervan
authors.forename: W
authors.initials: W
authors.lastname: Weimar
authors.forename: A J
authors.initials: AJ
authors.lastname: Bogers
mesh_terms: D000818:Animals; D001021:Aortic Valve / Q000473:pathology / Q000637:transplantation*; D005355:Fibrosis; D006084:Graft Rejection; D008297:Male; D051381:Rats; D011914:Rats, Inbred BN; D016042:Transplantation, Heterotopic; D014184:Transplantation, Homologous