摘要
目的:观察新型房间隔造口支架置入动物体内后的组织学反应,评价其可行性及安全性。方法:选用杂种实验犬8只,非体外循环下通过介入或外科方法进行创伤性房间隔造口术,直视下或经超声及透视下引导置入不同大小的新型房间隔造口支架,术后1周、2周、3周、4周、8周分别进行超声心动图检查了解造口通畅性,并处死动物进行大体解剖、光镜和电镜观察。结果:8只实验犬中例3犬因术中心室颤动死亡、例4犬术后12 h因心力衰竭死亡、例1犬造口支架置入右心房耳部;5只实验犬于房间隔成功置入造口支架,并存活1周以上,其中3只实验犬置入直径6 mm的造口支架,2只置入直径10 mm造口支架。超声心动图提示5只实验犬术后1周造口支架内全部通畅,术后2周发现例5犬造口支架内赘生物形成并造成支架内堵塞,术后3周、4周、8周超声发现另三只犬造口支架闭塞。术后3～8周的动物大体标本显示各组造口支架内填充以肉芽组织,支架表面均覆盖一层厚薄不等的、光滑的新生内膜组织,肺、肝、脾、肾脏等重要脏器均无细胞坏死、血栓栓塞现象。结论:动物实验证实了新型房间隔造口支架具有良好的经导管置入可行性,但造口通畅性不佳。造口支架局部结构还需进一步改进以减少组织增生和血栓形成。
Objective ： To evaluate the biocompatibility and safety of a specially designed novel stent for atrial septostomy in experimental canine. Methods ： A total of 8 experimental canines were used and the traumatic atrial septal defect model was established by surgical or interventional procedure without extracorporeal circulation, and 6mm and 10mm stents were simultaneously implanted during septostomy procedure. All animals were follow-up by echocardiography at 1,2,3,4 and 8 weeks after stent implantation respectively. The canine was killed to observe the anatomical and histological changes. Results ：2 dogs died of arrhythmia and heart failure during the procedure, 1 had misplaced stent. 5 dogs were implanted successfully, 3 of them receive 6mm stents and 2 received 10mm stents. Echocardiography indicated that no in-stent obstruction 1 week after the procedure in all 5 animals. 1 dog had in-stent obstruction by granulation tissue 2 weeks after the procedure and 3 dogs had in-stent obstruction 3,4,8 weeks after the procedure, Gross examination found the in-stent granulation and microscopy found a layer of smooth neoendocardium at the surface of all stents. No embolization and necrosis were observed in the important organs as lung, liver, spleen, and kidney. Conclusion：Our work suggests that a specially designed novel stent for atrial septostomy has good implantation feasibility, while the local structural design should be further improved to increase the traffic flow and to decrease the thrombus formation.
出处
《中国循环杂志》
CSCD
北大核心
2011年第5期390-392,共3页
Chinese Circulation Journal
基金
国家教育部博士点基金新教师项目(20070023084)
