CAJ | 학술논문

目的建立一种新的三尖瓣关闭不全(TR)致右心重构的动物模型.方法以比格犬为实验对象,采用右侧开胸短时阻断上、下腔静脉,切开右心房,心脏不停跳直视下剪除三尖瓣叶,根据术中心脏超声TR与右心房面积比(TR/RA)分为重度TR组(n=8,40％≤TR/RA＜ 70％)、极重度TR组(n=3,TR/RA≥70％),假手术组为对照组(n=3,无TR).超声心动图定期追踪检查,对饲养满18个月的2条犬处死,取器官组织标本.结果手术成功率为100％,最长饲养超过540 d,存活率为100％.手术组犬体质量逐渐增加,部分犬出现腹水.超声心动图提示右心房、右心室增大,右心功能减退,处死的手术组比格犬解剖发现肝硬化及大量腹水,提示发生右心重构和右心衰竭.假手术组手术前后未见差异.结论直视下剪除三尖瓣叶可成功建立TR致右心重构的动物模型,具有操作简单、可控性强、存活率高等特点,是研究右心重构的理想动物模型.
목적 건립일충신적삼첨판관폐불전(TR)치우심중구적동물모형.방법 이비격견위실험대상,채용우측개흉단시조단상、하강정맥,절개우심방,심장불정도직시하전제삼첨판협,근거술중심장초성TR여우심방면적비(TR/RA)분위중도TR조(n=8,40％≤TR/RA＜ 70％)、겁중도TR조(n=3,TR/RA≥70％),가수술조위대조조(n=3,무TR).초성심동도정기추종검사,대사양만18개월적2조견처사,취기관조직표본.결과 수술성공솔위100％,최장사양초과540 d,존활솔위100％.수술조견체질량축점증가,부분견출현복수.초성심동도제시우심방、우심실증대,우심공능감퇴,처사적수술조비격견해부발현간경화급대량복수,제시발생우심중구화우심쇠갈.가수술조수술전후미견차이.결론 직시하전제삼첨판협가성공건립TR치우심중구적동물모형,구유조작간단、가공성강、존활솔고등특점,시연구우심중구적이상동물모형.
Objective To establish a new animal model of right heart remodeling caused by tricuspid regurgitation.Methods The beagle dogs were taken as experimental objects (n =14).Firstly,the superior and inferior vena cava were blocked briefly,secondly the right atrium was open,at last the tricuspid valves of beagle dogs were cut off under direct vision on the beating heart.The dogs were divided into operation group and sham operation group at random.Through the echocardiography data of pre-operation,post-operation 3,6,12 months respectively and autopsy results after sacrifice of two animals whom had been raised for 18 months to estimate right ventricular remodeling happens or not.Results 8 beagle dogs were cut off the anterior tricuspid valve,and 3 dogs were cut off the anterior and posterior tricuspid valves with 100％ successful rate and 100％ survival rate.According to the ratio of TR area and right atrial area (TR/RA),the beagle dogs were divided into severe TR group (40％ ≤TR/RA ＜70％) with 8 dogs and very severe TR group (TR/RA ≥70％) with 3 dogs and sham operation group with 3 dogs.The longest one has raised above 540 days,and no natural death occurred so far.The weight of operation group increased,and the echocardiography showed right atrium and ventricle enlargement and right heart dysfunction.The autopsy of one of operation group dogs found liver cirrhosis and ascites.All of the results indicated the occurrence of right heart remodeling and right heart failure.There is no significant difference in sham operation group before or after operation.Conclusion By cutting off the tricuspid valves through lateral thoracotomy can established a new animal model of right heart remodeling caused by tricuspid regurgitation successfully,which is controllable,repeatable and high successful and survival rate.It is an ideal animal model for the study of right heart remodeling.