微创球囊堵闭法建立猪心肌梗死模型及其手术并发症的预防和处理

A Minimally Invasive Close-chest Method for Creating Myocardial Infarction in Porcines with Balloon and the Prevention or Management of the Complications

目的探讨运用微创冠状动脉球囊堵闭法建立猪急性心肌梗死模型的实验方法及其手术过程中并发症的处理。方法猪麻醉后经右侧股动脉置入冠状动脉球囊导管至左前降支远端堵闭120 m in,直至心电图证实心肌梗死形成。结果21只苏中幼猪均完成了冠状动脉造影及球囊封堵术,1只因术中失血过多在术后饲养过程中死亡,2只因封堵结束撤管时出现缓慢性心律失常和呼吸骤停,经抢救无效死亡。心电图监护显示典型急性心肌梗死图形演变过程,血清肌钙蛋白明显升高且呈动态变化,4周后病理标本显示疤痕形成,切片显示典型心肌梗死病理改变。结论微创球囊冠状动脉堵闭法为一种简单安全的建立心肌梗死模型的方法,术中并发症的预防及处理是保证存活率的关键。

Objective To evaluate a closed-chest technique of chronic coronary artery occlusion at a selected location with use of balloon inflation in porcines and discuss the prevention and management of complications during or after operation. Methods The occlusion at the distal of LAD was performed with percutaneous transluminlar coronary angioplasty（PTCA） balloon via fight femoral artery under fluoroscopic guide, ECG was continuously monitored during the procedure and confn＇med acute myocardial infarction after the balloon occlusion after 120 min. Results The balloon occlusion was successfully performed in 21 percines. Two perclnes died during withdrawal of PTCA balloon catheter due to bradyarrhythmia and apnea. One died after the procedure during feeding. ECG demonstrated the typical change of acute myocardial infarction and cardiac tropenin increased in all percines. After 4 weeks there was typical pathological changes in the infarction tissue. Conclusion The technique of LAD occlusion presents a less invasive alternative to open chest models. Proper prevention and management of the complications could reduce mortality rate.