连续缝合端侧吻合技术建立大鼠腹腔异位心脏移植模型的研究

Establishment of rat abdominal heterotopic heart transplantation model by end-to-side continuous suturing anastomosis

目的对经典Ono式异位心脏移植模型进行改良,建立SD-Wistar大鼠腹腔异位心脏移植模型,并探讨相关显微外科手术操作技巧。方法SPF级雄性SD及Wistar大鼠各50只,全身麻醉后取SD大鼠心脏作为供心,在左锁骨下动脉以远5mm处切断胸主动脉作为供血动脉,将左肺动脉作为供心静脉。受体采用Wistar大鼠,充分游离腹主动脉与下腔静脉,选择左肾动脉远心端约5mm附近的腹主动脉及下腔静脉作为吻合口部位,将腹主动脉与下腔静脉的吻合口部位置于不同平面。采用连续缝合的方式分别将供心胸主动脉、左肺动脉与受体腹主动脉、下腔静脉进行端侧吻合。结果通过该方法建立腹腔异位心脏模型,每例SD-Wistar心脏移植模型总手术时间(60±10)min,其中供心切取时间(10±3)min,受体腹主动脉及下腔静脉游离时间(4±2)min,血管吻合(12±5)min。实验动物术中及术后分均无死亡,术后所有供心全部复跳。2例供心在术后第3天出现搏动减弱,于第5天出现供心停跳。其余大鼠术后1周观察仍存在规律心跳。结论经改良成功建立了SD-Wistar大鼠腹腔异位心脏移植模型。

Objective To establish the SD-Wistar rat abdominal heterotopic heart transplantation model through modifying the classic Ono′s heterotopic heart transplantation model,and to discuss the related microsurgical operation skills. Methods Each 50 SPF class male SD and Wistar rats were selected in the study.After general anesthesia,the rat heart was taken as the donor heart.The thoracic aorta was cut off at 5mm distal to the left subclavian artery,which was used as the supplying artery,and the left pulmonary artery was used as the donor heart′s venous system.Wistar rats were selected as recipients,the abdominal aorta and inferior vena cava were sufficiently dissected from each other.The distal end 5mm below the left renal artery was chosen as the site for end-to-side anastomosis,and the anastomotic site of the abdominal aorta and inferior vena cava are not on the same level.And the heart transplantation was performed by using continuous suturing anastomosis of donor′s ascending aorta to recipient′s abdominal aorta,and donor′s left pulmonary artery to recipient′s inferior vena cava. Results The abdominal heterotopic heartmodel was established by this method.The total operation time was (60±10)min for each case of SD-Wistar heart transplantation,in which the preparing time of donor′s heart was (10±3)min,the dissection time of recipient′s abdominal aorta and inferior vena cava was ( 4±2 )min,the end-to-side vascular anastomosis time was (12±5)min.No death of experimental animals occurred during and after operation.All donors′ hearts rebeated after the circulation was recreated.In two cases,the transplanted hearts appeared the beat weakness on postoperative 3 d and stopped beating on 5 d.And regular heart beat could be found one week after the operation in the remaining 48 cases. Conclusion The SD-Wistar abdominal heterotopic heart transplantation model is successfully established by the modified Ono′s technique.