title: Surgical left ventricular radius enlargement by patch insertion on the beating heart: a new experimental aneurysm model.
abstract: We presented a novel experimental aneurysm model for studies in left ventricular (LV) reconstruction techniques and assessed LV function. In eight pigs, the LV radius and geometry were enlarged surgically on the beating heart by inserting an aortic allograft construct. Haemodynamics and LV dimensions were assessed by echocardiography at baseline and under dobutamine stress. Surgery was successfully performed without lethal blood loss or arrhythmias. LV end-diastolic and end-systolic short-axis areas increased from 13.0 ± 1.7 to 17.0 ± 4.3 cm(2) (P = 0.001) and from 4.0 ± 0.9 to 13.0 ± 2.6 cm(2) (P = 0.001), respectively. Stroke volume decreased from 56 ± 11 to 33 ± 16 ml (P = 0.001). Incremental dobutamine infusion concurred with a biphasic response on fractional area shortening. Mitral valve insufficiency ranging from grades 2 to 4 was observed. In the pig, a novel, reproducible aneurysm model for acute cardiac dysfunction was created on the beating heart. Innovative (surgical) strategies for (staged) reconfiguration of the ventricle, e.g. adjustable Dor procedures and stepwise volume restraining cardiac support devices, can be tested for efficacy using this acute model.
authors.affiliation: Experimental Cardiology Laboratory, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands. p.f.grundeman@umcutrecht.nl
authors.forename: Paul F
authors.initials: PF
authors.lastname: Gründeman
authors.forename: Tycho I G
authors.initials: TI
authors.lastname: van der Spoel
authors.forename: Paul
authors.initials: P
authors.lastname: Steendijk
authors.forename: Frebus
authors.initials: F
authors.lastname: van Slochteren
authors.forename: Maarten Jan M
authors.initials: MJ
authors.lastname: Cramer
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
authors.forename: Gerard
authors.initials: G
authors.lastname: Pasterkamp
mesh_terms: D000818:Animals; D001011:Aorta / Q000637:transplantation*; D001794:Blood Pressure; D006348:Cardiac Surgical Procedures; D002316:Cardiotonic Agents / Q000008:administration & dosage; D004195:Disease Models, Animal; D004280:Dobutamine / Q000008:administration & dosage; D006322:Heart Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006339:Heart Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000503:physiopathology; D013318:Stroke Volume; D013552:Swine; D014184:Transplantation, Homologous; D014463:Ultrasonography; D016277:Ventricular Function, Left
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine