经静脉穿刺制备犬室间隔缺损模型的实验研究

Ventricular septal defect produced by transcatheter puncture for canine model experimental study

目的 经静脉穿刺制备室间隔缺损 (VSD)模型。方法 健康杂种犬 10只 ,体重 15～2 0kg。氯胺酮 (5mg/kg)肌注、戊巴比妥钠 (2 5mg/kg)静脉麻醉。切开右股动脉和右颈内静脉 ,在X线透视下应用房间隔穿刺针穿刺室间隔 ,经穿刺针送入鞘管 ,交换头端弯曲 1.5圈的左房钢丝至左心室 ,沿钢丝送入直径 6～ 8mm长 4 0mm聚乙烯球囊扩张室间隔穿刺孔。送入猪尾造影导管至左心室 ,行左心室造影。结果 10只犬中 ,8只犬均穿刺成功 ,并建立VSD模型。 8只犬中 ,除 1例穿刺点在室间隔膜部 ,其余穿刺部位均接近于膜周部 ,穿刺点距主动脉瓣和房室瓣环 4～ 16mm不等。左心室造影显示经室间隔的左向右分流。并发完全性右束支传导阻滞 1例。Ⅲ度房室传导阻滞伴室间隔膜部及房室瓣环处撕裂 1例。结论 经导管穿刺室间隔制备VSD模型的方法可行 ,简便 。

Objective To develope a new method producing ventricular septal defect (VSD) model by transcatheter puncture and evaluate its feasibility and practicability. Methods Ten dogs underwent transcatheter ventricular septal puncture with Brockenbrough puncture needle via right jungular vein under fluoroscopy, and then dilated the defect with 6-8mm balloon catheter. Left ventricular (LV) angiography was performed with pigtail catheter by transaortic access after puncture. Right after the procedure and 1-4 months later, the dogs were sacrificed and the defects were inspected. Results VSDs were successfully made in 8 dogs, which were demonstrated by LV angiography with one defect at membranous part. The defects in other dogs were shown near membranous septum or muscular septum not far away from the membranous part. The distance from aortic valves to the rims of defect was 4-16mm, from tricuspid valves 4-10mm. Ⅲ°AVB was found in 1 dog which died 1 week later, with ruptured membranous part at autopsy. CRBBB was found in another dog. Conclusion Establishment of VSD animal by transcatheter puncture is feasible, practicable and of high successful rate and less complication.