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A Reproducible Ovine Model of Right Heart Failure by RCA Ligation
Marisa Cevasco, MD, MPH1, Michael Kwon, MD1, Ravi V. Shah, MD2, Rita Laurence, BA1, Raymond H. Kwong, MD2, Lawrence H. Cohn, MD1, R. Morton Bolman, III, MD1, Frederick Y. Chen, MD, PhD1
1Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, MA; 2Department of Cardiology, Brigham and Women's Hospital, Boston, MA
Introduction: Right heart failure is an important clinical entity in adult and congenital cardiac surgery. There are few large animal models of right heart failure to study this problem. We sought to establish a stable, reproducible large animal model of right heart failure.
Methods: Eight healthy male sheep underwent a right thoracotomy. The pericardium was opened, and identification of the right coronary artery (RCA) followed. The RCA was ligated using 3-0 polypropylene suture. The sheep were recovered uneventfully and allowed to develop right heart failure for six weeks. All animals underwent perfusion-gated cardiac magnetic resonance imaging (MRI) after this time interval. Two animals also underwent MRI under general anesthesia pre-RCA ligation for evaluation of baseline function. Volumetric analysis was performed and normalized over body surface area, and ejection fraction and RV volume were calculated.
Results: All eight sheep survived the surgery and recovered uneventfully. Complete MRIs were performed on three sheep while five sheep are still developing heart failure. RV ejection fraction (EF) decreased to 36% from a baseline 58% (p<.05). End diastolic RV volume in heart failure sheep increased to 85 mL/m2 from 60 mL/m2 at baseline (p<.05).
Conclusions: Right coronary artery ligation is a stable, reproducible method to model chronic right heart failure in an ovine model. This may be used to study right heart failure and remodeling with clinical relevance to both adult and congenital right heart physiology and failure.
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