Consequences of an early catheter-based intervention on pulmonary artery growth and right ventricular myocardial function in a pig model of pulmonary artery stenosis

Autor: Luke Lamers, Petros V. Anagnostopoulos, Jenna N. Torgeson, Jamie L. Reichert, Cole Nygard, Marlowe W. Eldridge, Csaba Galambos, Melissa L. Bates
Rok vydání: 2018
Předmět:
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Sus scrofa
0206 medical engineering
Hemodynamics
02 engineering and technology
Pulmonary Artery
030204 cardiovascular system & hematology
Prosthesis Design
Contractility
03 medical and health sciences
0302 clinical medicine
Early Medical Intervention
Internal medicine
medicine.artery
Animals
Medicine
Stenosis
Pulmonary Artery
Radiology
Nuclear Medicine and imaging
business.industry
Pulmonary artery stenosis
Stent
General Medicine
medicine.disease
Myocardial Contraction
020601 biomedical engineering
Prosthesis Failure
Disease Models
Animal
Stenosis
Animals
Newborn
Catheterization
Swan-Ganz
Pulmonary artery
Ventricular Function
Right
Cardiology
Stents
Dobutamine
Implant
Cardiology and Cardiovascular Medicine
business
medicine.drug
Zdroj: Catheterization and Cardiovascular Interventions. 92:78-87
ISSN: 1522-1946
DOI: 10.1002/ccd.27593
Popis: OBJECTIVE To determine the consequences of an early catheter-based intervention on pulmonary artery (PA) growth and right ventricular (RV) myocardial function in an animal model of branch PA stenosis. BACKGROUND Acute results and safety profiles of deliberate stent fracture within the pulmonary vasculature have been demonstrated. The long-term impact of early stent intervention and deliberate stent fracture on PA growth and myocardial function is not understood. METHODS Implantation of small diameter stents was performed in a pig model of left PA stenosis at 6 weeks (10 kg) followed by dilations at 10 (35 kg) and 18 weeks (65 kg) with intent to fracture and implant large diameter stents. Hemodynamics, RV contractility, and 2D/3D angiography were performed with each intervention. The heart and pulmonary vasculature were histologically assessed. RESULTS Stent fracture occurred in 9/12 and implantation of large diameter stents was successful in 10/12 animals with no PA aneurysms or dissections. The final stented PA segment and distal left PA branch origins equaled the corresponding PA diameters of sham controls. Growth of left PA immediately beyond the stent was limited and there was diffuse fibro-intimal proliferation within the distal left and right PA. RV contractility was diminished in the intervention group and the response to dobutamine occurred uniquely via increases in heart rate. CONCLUSIONS Early stent intervention in this surgically created PA stenosis model was associated with improved growth of the distal PA vasculature but additional investigation of PA vessel physiology and impact on the developing heart are needed.
Databáze: OpenAIRE
Externí odkaz: