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Carney JP, Bianco RW. Multimodal preoperative imaging for transcatheter mitral valve replacement in the domestic sheep model. Sci Rep 2024; 14:11745. [PMID: 38778204 PMCID: PMC11111800 DOI: 10.1038/s41598-024-62646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/20/2024] [Indexed: 05/25/2024] Open
Abstract
Preclinical in vivo evaluation is an essential step in the progression of new cardiac devices into patient use, with studies predominantly performed in the domestic sheep model. A growing area of interest in cardiac device development is transcatheter mitral valve replacement (TMVR). Clinically, multimodal imaging, or computed tomography (CT) and echocardiography (echo) are used extensively to preoperatively determine mitral valve morphology prior to an intervention, but there is no description on how these modalities can be implemented to support preclinical studies. The purpose of this study is to apply clinically relevant CT and echo acquisition and assessment techniques to a large group of naive research sheep in order to analyze and report modality-related effects on mitral valve dimensional reference intervals in the sheep model. To this end, fifty-five adult domestic sheep underwent preoperative CT and echo exams and resultant images were analyzed using a landmark-based multiplanar measurement protocol and compiled into a master dataset for statistical analysis. We found moderate agreement between CT and echo-derived measurements of the mitral valve in sheep and propose the first clinically-relevant dimensional indices for the sheep's naive mitral valve which can be used to guide future studies evaluating novel TMVR devices. This study is the first of its kind in proposing a reproducible method for detailed examination of the mitral valve in the sheep model using clinically-relevant multimodal imaging. As in patients, CT and echo can reveal accurate native mitral valve dimensions in the sheep prior to preclinical TMVR studies.
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Affiliation(s)
- John P Carney
- Experimental Surgical Services Laboratory, Department of Surgery, University of Minnesota Minneapolis, 425 East River Parkway KE B18, Minneapolis, MN, 55455, USA.
| | - Richard W Bianco
- Experimental Surgical Services Laboratory, Department of Surgery, University of Minnesota Minneapolis, 425 East River Parkway KE B18, Minneapolis, MN, 55455, USA
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van Doorn ECH, Amesz JH, Sadeghi AH, de Groot NMS, Manintveld OC, Taverne YJHJ. Preclinical Models of Cardiac Disease: A Comprehensive Overview for Clinical Scientists. Cardiovasc Eng Technol 2024; 15:232-249. [PMID: 38228811 PMCID: PMC11116217 DOI: 10.1007/s13239-023-00707-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 12/19/2023] [Indexed: 01/18/2024]
Abstract
For recent decades, cardiac diseases have been the leading cause of death and morbidity worldwide. Despite significant achievements in their management, profound understanding of disease progression is limited. The lack of biologically relevant and robust preclinical disease models that truly grasp the molecular underpinnings of cardiac disease and its pathophysiology attributes to this stagnation, as well as the insufficiency of platforms that effectively explore novel therapeutic avenues. The area of fundamental and translational cardiac research has therefore gained wide interest of scientists in the clinical field, while the landscape has rapidly evolved towards an elaborate array of research modalities, characterized by diverse and distinctive traits. As a consequence, current literature lacks an intelligible and complete overview aimed at clinical scientists that focuses on selecting the optimal platform for translational research questions. In this review, we present an elaborate overview of current in vitro, ex vivo, in vivo and in silico platforms that model cardiac health and disease, delineating their main benefits and drawbacks, innovative prospects, and foremost fields of application in the scope of clinical research incentives.
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Affiliation(s)
- Elisa C H van Doorn
- Translational Cardiothoracic Surgery Research Lab, Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
- Translational Electrophysiology Laboratory, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jorik H Amesz
- Translational Cardiothoracic Surgery Research Lab, Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
- Translational Electrophysiology Laboratory, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Amir H Sadeghi
- Translational Cardiothoracic Surgery Research Lab, Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Natasja M S de Groot
- Translational Electrophysiology Laboratory, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Yannick J H J Taverne
- Translational Cardiothoracic Surgery Research Lab, Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
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Buszman PP, Kachel M, Ceballos CF, Łukasik K, Domaradzki W, Pruski M, Tellez A, Rousselle S, Konopko M, Glanc M, Kaźmierczak P, Milewski KP, Buszman PE. 6-Month Evaluation of a Transcatheter Aortic Valve (Myval) in a Novel Ovine, Supra-Aortic Banding Model. JACC Basic Transl Sci 2022; 7:486-495. [PMID: 35663633 PMCID: PMC9156430 DOI: 10.1016/j.jacbts.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 10/26/2022]
Abstract
The aim of the study was to evaluate a balloon expandable transcatheter heart valve (THV) system (Myval) at 6-month follow-up in ovine banding model. Eleven THV systems were implanted via carotid approach. There were 2 procedure-related deaths and 2 premature deaths. At 6 months all valves that completed follow-up (n = 7) were functional, with no significant regurgitation, calcification, thrombi, or vegetation. Mean pressure gradient was 21.9 ± 11 mm Hg, maximum velocity = 3.3 ± 1 m/s, and ejection fraction was 53.3 ± 6%. Myval THV showed optimal hemodynamic performance and biocompatibility.
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Affiliation(s)
- Piotr P Buszman
- Department of Cardiology, Andrzej-Frycz Modrzewski Kraków University, Bielsko-Biała, Poland.,Center for Cardiovascular Research and Development, American Heart of Poland, Kostkowice, Poland
| | - Mateusz Kachel
- Center for Cardiovascular Research and Development, American Heart of Poland, Kostkowice, Poland
| | | | - Karolina Łukasik
- Center for Cardiovascular Research and Development, American Heart of Poland, Kostkowice, Poland
| | - Wojciech Domaradzki
- Center for Cardiovascular Research and Development, American Heart of Poland, Kostkowice, Poland
| | - Maciej Pruski
- Department of Cardiology, Andrzej-Frycz Modrzewski Kraków University, Bielsko-Biała, Poland.,Center for Cardiovascular Research and Development, American Heart of Poland, Kostkowice, Poland
| | - Armando Tellez
- Instituto Tecnológico de Estudios Superiores de Monterrey, Monterrey, Mexico
| | | | - Marta Konopko
- Department of Cardiology, Andrzej-Frycz Modrzewski Kraków University, Bielsko-Biała, Poland
| | - Michał Glanc
- Center for Cardiovascular Research and Development, American Heart of Poland, Kostkowice, Poland
| | - Paweł Kaźmierczak
- Center for Cardiovascular Research and Development, American Heart of Poland, Kostkowice, Poland
| | - Krzysztof P Milewski
- Center for Cardiovascular Research and Development, American Heart of Poland, Kostkowice, Poland.,University of Technology, Faculty of Medicine, Katowice, Poland
| | - Pawel E Buszman
- Center for Cardiovascular Research and Development, American Heart of Poland, Kostkowice, Poland.,Department of Epidemiology, Medical University of Silesia, Katowice, Poland
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Modine T, Ben Ali W, Perrin N. Large Animal Models for Transcatheter Heart Valve Prosthesis Development: Making Sheep's Eyes at Supra-Annular Banding. JACC Basic Transl Sci 2022; 7:496-497. [PMID: 35663627 PMCID: PMC9156445 DOI: 10.1016/j.jacbts.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Thomas Modine
- Service Médico-Chirurgical: Valvulopathies-Chirurgie Cardiaque-Cardiologie Interventionelle Structurelle, Hôpital Cardiologique de Haut Lévèque, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Walid Ben Ali
- Structural Heart Intervention Program, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Nils Perrin
- Structural Heart Intervention Program, Montreal Heart Institute, Montreal, Quebec, Canada.,Cardiology Division, Geneva University Hospitals, Geneva, Switzerland
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Faustich JTS, Carney JP, Lahti MT, Zhang BL, Bianco RW. Establishing Background Pathologic Changes of Valve Replacement Surgery in Sheep. Cardiovasc Eng Technol 2021; 13:181-190. [PMID: 34263418 PMCID: PMC8888364 DOI: 10.1007/s13239-021-00563-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/01/2021] [Indexed: 12/02/2022]
Abstract
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. Supplementary Information The online version contains supplementary material available at 10.1007/s13239-021-00563-6.
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Affiliation(s)
- Jill T Schappa Faustich
- Experimental Surgical Services Laboratory, Department of Surgery, University of Minnesota, Minneapolis, MN, 55455, USA
| | - John P Carney
- Experimental Surgical Services Laboratory, Department of Surgery, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Matthew T Lahti
- Experimental Surgical Services Laboratory, Department of Surgery, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Benjamin L Zhang
- Experimental Surgical Services Laboratory, Department of Surgery, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Richard W Bianco
- Experimental Surgical Services Laboratory, Department of Surgery, University of Minnesota, Minneapolis, MN, 55455, USA
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