A critical appraisal of open- and closed-chest models of experimental myocardial ischemia.

Myocardial ischemia is one of the most extensively studied topics in modern cardiovascular research. Early investigators first reported experimental myocardial ischemia (EMI) in 1862. The open-chest (surgical) approach is a well-developed model of EMI that enables researchers to directly access and observe the heart. With this approach, EMI is generally induced by surgical ligation of a coronary artery. A drawback of the open-chest model is the need for major surgery, which can result in local and systemic side effects. Alternative closed-chest models of EMI have been developed; most of these models involve endovascular catheterization with coronary artery embolization or thrombosis. Closed-chest techniques eliminate the need for invasive surgery, and the resultant model is more physiologically similar to clinical myocardial ischemia than is EMI produced by artery ligation. The authors present a review of open- and closed-chest models of EMI and discuss the advantages and disadvantages of each approach.