绵羊植入左心室辅助装置在体实验手术管理

目的探讨绵羊植入左心室辅助装置(left ventricular assist device,LVAD)在体实验手术管理的特殊要求。方法依照北京市实验动物管理条例,参考美国动物管理及使用委员会关于植入式LVAD实验动物评判标准和国际上LVAD动物实验经验,进行国产植入式LVAD绵羊在体存活实验。成年绵羊在心脏不停跳状态下完成LVAD植入手术,针对手术的特性,制定术前、围术期及术后的管理措施。结果成功实施6例绵羊植入式LVAD在体实验,1例LVAD在植入25 d后停止运转,1例实验动物在术后第3天因肺部感染死亡,其余4例实验动物植入后存活状态良好,达到在体实验30 d的实验预期。结论术前的精心准备、遵循严格的手术操作规程、术后早期严密的监护、术后精心护理以及选择合理的抗凝策略可有效的提高绵羊植入式LVAD慢性存活实验的成功率。

Surgery management of implantable left ventricular assist device in sheep model

Objective We performed this study to explore particular management requirement on sheep experimental implantation of left ventricular assist device(LVAD). Methods In accordance with the Beijing Laboratory Animal Management Regulations, the criteria of American Association for Laboratory Animal Science(AALAS) and the experiences of the other in vivo animal experiments of the LVAD, we implanted the LVAD in the ovine model. The LVADs were implanted in healthy sheep on beating heart. Considering with the characteristics of the animals and in accordance with the requirements of the LVAD, the managements were formulated on aspects of the perioperative, the perioperative and the postoperative. Results In total 6 sheep survived the surgical procedure, one case was terminated because of lung infection 3 days after the surgery, one case was terminated because of the inflow cannula obstruction associated with a thrombus and cellular fibrous tissue growths at the LV apex 25 days after the surgery, and the remaining four cases survived in good condition after implantation and reached the 30 d expectations. Conclusion Careful preparation before the surgery, development of strict surgical procedure, rigorous early postoperative care and a reasonable choice of anticoagulant strategies can effectively improve the success rate of implantable experiments.