Intravascular imaging of atherosclerotic human coronaries in a porcine model: a feasibility study.
OBJECTIVE
To perform intravascular imaging of atherosclerotic human coronary conduits in an animal model under conditions of flow and cardiac motion that approximate those encountered in vivo.


BACKGROUND
Given the lack of animal models of vulnerable plaque, a model which would allow imaging of human disease and simulate coronary motion and blood flow could advance the development of emerging technologies to detect vulnerable plaques.


METHODS
Human coronary segments from adult cadaver hearts were prepared as xenografts. In anesthetized Yorkshire pigs (45-50 kg) the chest was opened and the exposed aorta and right atrium were cannulated and attached in an end-to-end fashion to the human coronary xenograft, forming an aorto-atrial conduit. The xenograft was fixed to the anterior wall of the heart to simulate motion. Angiography and intravascular ultrasound (IVUS) of each graft were performed.


RESULTS
Twelve human coronary grafts (10 from right coronary segments) were prepared and implanted successfully in seven animals. All animals tolerated the procedure. The average graft length was 39 +/- 2.3 mm. Blood flow rates distal to the graft were >100 ml/min in nine grafts. IVUS was performed in all 12 grafts and documented expansion of arterial (6.9%) and luminal (9.3%) dimensions during the cardiac cycle (P < 0.001 for both). There was a wide range of coronary atherosclerotic pathology within the grafts, including intimal thickening, fibrocalcific plaque, and deep lipid pools.


CONCLUSIONS
This human-to-porcine coronary xenograft model allows intravascular imaging of human coronary pathology under conditions of blood flow and motion, and may be used to develop technologies aimed at identifying high-risk plaques.
Waxman
Sergio
S
Department of Medicine and the Center for Translational Cardiovascular Research, Tufts-New England Medical Center, Boston, MA, USA. sergio.waxman@lahey.org
Khabbaz
Kamal
K
Connolly
Raymond
R
Tang
Jing
J
Dabreo
Alexandra
A
Egerhei
Lara
L
Ishibashi
Fumiyuki
F
Muller
James E
JE
Tearney
Guillermo M
GM
D000328:Adult; D000818:Animals; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D004195:Disease Models, Animal; D005240:Feasibility Studies; D006439:Hemodynamics; D006801:Humans; D012107:Research Design; D013552:Swine; D014183:Transplantation, Heterologous; D018084:Ultrasonography, Interventional