Hussam Al Hussein1,2, Hamida Al Hussein3, Carmen Sircuta1, Ovidiu S Cotoi1, Ionela Movileanu1,2, Dan Nistor1,2, Bogdan Cordos1, Radu Deac1, Horatiu Suciu1,2, Klara Brinzaniuc1, Dan T Simionescu1,4, Marius M Harpa1,2. 1. Tissue Engineering and Regenerative Medicine Laboratory "TERMLab", The University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Tirgu Mures, 38 Gh. Marinescu Street, 540139, Tirgu Mures, Romania. 2. The Emergency Institute for Cardiac Diseases and Transplantation of Tirgu Mures, 50 Gh. Marinescu Street, 540136, Tirgu Mures, Romania. 3. Tissue Engineering and Regenerative Medicine Laboratory "TERMLab", The University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Tirgu Mures, 38 Gh. Marinescu Street, 540139, Tirgu Mures, Romania. hamida.alhussein@yahoo.com. 4. Clemson University, 306 Rhodes Annex, Clemson, SC, 29634, USA.
Abstract
BACKGROUND: Development of valvular substitutes meeting the performance criteria for surgical correction of congenital heart malformations is a major research challenge. The sheep is probably the most widely used animal model in heart valves regenerative medicine. Although the standard cardiopulmonary bypass (CPB) technique and various anesthetic and surgical protocols are reported to be feasible and safe, they are associated with significant morbidity and mortality rates. The premise of this paper is that the surgical technique itself, especially the perioperative animal care and management protocol, is essential for successful outcomes and survival. METHODS: Ten juvenile and adult female sheep aged 7.8-37.5 months and weighing 32.0-58.0 kg underwent orthotopic implantation of tissue-engineered pulmonary valve conduits on beating heart under normothermic CPB. The animals were followed-up for 6 months before scheduled euthanasia. RESULTS: Based on our observations, we established a guide for perioperative care, follow-up, and treatment containing information regarding the appropriate clinical, biological, and ultrasound examinations and recommendations for feasible and safe anesthetic, surgical, and euthanasia protocols. Specific recommendations were also included for perioperative care of juvenile versus adult sheep. CONCLUSION: The described surgical technique was feasible, with a low mortality rate and minimal surgical complications. The proposed anesthetic protocol was safe and effective, ensuring both adequate sedation and analgesia as well as rapid recovery from anesthesia without significant complications. The established guide for postoperative care, follow-up and treatment in sheep after open-heart surgery may help other research teams working in the field of heart valves tissue regeneration.
BACKGROUND: Development of valvular substitutes meeting the performance criteria for surgical correction of congenital heart malformations is a major research challenge. The sheep is probably the most widely used animal model in heart valves regenerative medicine. Although the standard cardiopulmonary bypass (CPB) technique and various anesthetic and surgical protocols are reported to be feasible and safe, they are associated with significant morbidity and mortality rates. The premise of this paper is that the surgical technique itself, especially the perioperative animal care and management protocol, is essential for successful outcomes and survival. METHODS: Ten juvenile and adult female sheep aged 7.8-37.5 months and weighing 32.0-58.0 kg underwent orthotopic implantation of tissue-engineered pulmonary valve conduits on beating heart under normothermic CPB. The animals were followed-up for 6 months before scheduled euthanasia. RESULTS: Based on our observations, we established a guide for perioperative care, follow-up, and treatment containing information regarding the appropriate clinical, biological, and ultrasound examinations and recommendations for feasible and safe anesthetic, surgical, and euthanasia protocols. Specific recommendations were also included for perioperative care of juvenile versus adult sheep. CONCLUSION: The described surgical technique was feasible, with a low mortality rate and minimal surgical complications. The proposed anesthetic protocol was safe and effective, ensuring both adequate sedation and analgesia as well as rapid recovery from anesthesia without significant complications. The established guide for postoperative care, follow-up and treatment in sheep after open-heart surgery may help other research teams working in the field of heart valves tissue regeneration.
Authors: J Trent Magruder; Todd C Crawford; Herbert Lynn Harness; Joshua C Grimm; Alejandro Suarez-Pierre; Chad Wierschke; Jim Biewer; Charles Hogue; Glenn R Whitman; Ashish S Shah; Viachaslau Barodka Journal: J Thorac Cardiovasc Surg Date: 2016-09-19 Impact factor: 5.209
Authors: Helmgton José Brito de Souza; José Honório de Almeida Palma; Ivan Sérgio Joviano Casagrande; Sérgio Campos Christo; Luiz Sérgio Alves-Silva; Marco Antônio Cardoso de Almeida; Diego Felipe Gaia; Enio Buffolo Journal: Rev Bras Cir Cardiovasc Date: 2012 Jul-Sep
Authors: N J N Harper; T M Cook; T Garcez; D N Lucas; M Thomas; H Kemp; K-L Kong; S Marinho; S Karanam; K Ferguson; J Hitchman; H Torevell; A Warner; W Egner; S Nasser; N McGuire; M Bellamy; K Floss; L Farmer; S Farooque Journal: Br J Anaesth Date: 2018-05-21 Impact factor: 9.166