Name: Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure (Video) | JoVE Journal
Uploaded: 2026-01-16T12:45:00.000+00:00
Duration: 5 min 18 s
Description: Learn LVAD implantation in juvenile Landrace swine to study pediatric heart failure and ventricular reverse remodeling. This model supports development of safer cardiac assist devices for children.

ai_agent_IP

ai_agent

maintenance

instantTrialDurationMinutes

isBiopharma

enableNewMyJoveSectionDesign

educationFeatures

seoMetaApi

ai_copilot_institution_blacklist

ai_chat_institution_blacklist

freeAccessWindow

ssoRoleCapture

scheduledMaintenanceBanner

joveLabsFeatures

disable_autoplay_for_bots

extended_trial_duration

5 minutes

This work was sponsored by the National Natural Science Fund for Distinguished Young Scholars of China (82125004; to Jiangping Song), Evaluation of large animal experiments for self-developed pediatric-specific implantable ventricular assist device and preclinical confirmation of Clinical breakthroughs and establishment of diagnostic and treatment norms for end-stage heart failure in children (2023YFC2706204); Frontier Biotechnology Key Project of National Key R &#38; D Program of the Ministry of Science and Technology of China (2023YFC3404300; to Jiangping Song), Special Project of the Ministry of Science and Technology of China Supported by the State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, and Chinese Academy of Medical Sciences (2024GZZD-03; to Jiangping Song).

&#8203;All procedures involving pigs were approved by the Institutional Animal Care and Use Committee (IACUC) of Fuwai Hospital, Chinese Academy of Medical Sciences (ethical approval no.: 0109-1-35-ZX(X)-5). All of our experiments followed the ARRIVE guidelines. The experimental animals, three-month-old male juvenile landrace pigs (30-35kg), were housed and isolated in the experimental facilities of the Animal Center of Fuwai Hospital in advance to adapt to the environment and reduce stress. Animals were examined preoperatively to ensure their preoperative health, and were excluded from the experiment if they had abnormal behavioral characteristics, abnormal symptoms, or signs. The experimental animals were fasted and forbidden to drink before heart transplantation and examination according to the routine procedures of the animal experiment center.
1. Preoperative management and preparation of the experimental animal
NOTE: Animal welfare measures: Confirm health status pre-op. Provide thermal support (forced-air warming blanket) and maintain core temperature 37.0&#8211;38.5 &#176;C. Apply sterile ophthalmic lubricant to both eyes at induction and every 2&#8211;4 h during prolonged anesthesia. Confirm surgical plane (no palpebral reflex, minimal jaw tone, no response to toe pinch) before incision and reassess periodically. Continuously monitor ECG, SpO2, EtCO2, BP (non-invasive or invasive when catheterized), respiratory parameters, and core temperature; record at least every 5&#8211;10 min.
<ol>
	<li>Have the animals fast for 12 h and deprive them of water for 4 h before surgery.</li>
	<li>Premedicate/sedate with ketamine 10&#8211;20 mg/kg IM, then induce anesthesia with propofol 2&#8211;4 mg/kg IV to effect for endotracheal intubation.</li>
	<li>Establish venous access to the auricular vein.
	<ol>
		<li>Apply a tourniquet tightly at the base of the ear to engorge the vein.</li>
		<li>Use the non-dominant hand to stretch and stabilize the ear. Hold the catheter needle like a pencil with your dominant hand, bevel up, at a 15-30&#176; angle to the skin.</li>
		<li>Aseptic catheter placement: clip hair if needed; scrub insertion site with chlorhexidine (or povidone-iodine) alternating with 70% isopropyl alcohol &#215;3; use sterile gloves and sterile supplies; apply sterile dressing/transparent film after placement. Maintenance: flush with heparinized saline (e.g., 10 U/mL) 2&#8211;5 mL every 6&#8211;8 h and after medications; inspect site at least twice daily; replace if phlebitis/infection suspected. Puncture the skin and the vein wall in one smooth motion.</li>
		<li>Upon observing flashback blood in the chamber, advance the entire assembly another 1-2 mm. Then, stabilize the stylet (metal needle) and advance the plastic catheter fully into the vessel.</li>
		<li>Apply pressure to the skin over the catheter tip to prevent bleeding, swiftly withdraw the stylet, and dispose of it in a sharp container. Immediately connect a heparin cap or stopcock.</li>
		<li>Remove the tourniquet from the ear base. Aspirate with a syringe to observe blood return, confirming intravascular placement. Slowly flush with 1-2 mL of saline. Observe for any swelling around the site, indicating extravasation.</li>
		<li>Wrap the entire ear loosely with a cohesive bandage, ensuring the ear tip is exposed to monitor for ischemia.</li>
	</ol>
	</li>
	<li>Administer propofol (2-4 mg/kg IV) and perform endotracheal intubation. Preoxygenate with 100% O2&#160;for 3&#8211;5 min when possible. Apply ocular lubricant at induction. Provide padding under shoulders/hips/limbs and check pressure points periodically to prevent muscle ischemia/nerve injury.
	<ol>
		<li>Check and prepare a correctly sized endotracheal tube, laryngoscope (straight blade), stylet, syringe, lubricant, bite block/rolled gauze, securing tape, and stethoscope.</li>
		<li>Position the pig in a stable dorsal recumbency. Extend the neck and tilt the head back.</li>
		<li>Provide 100% oxygen via a face mask for 3-5 min if possible.</li>
		<li>Insert the laryngoscope blade into the right commissure of the mouth, advancing it while displacing the tongue to the left.</li>
		<li>Advance the blade along the midline of the tongue. Identify the epiglottis, then use the tip of the blade to gently lift and depress the epiglottis to expose the glottis (a vertical slit).</li>
		<li>As the glottis opens (during inspiration), advance the endotracheal tube (with stylet if used) through the right commissure into the trachea.</li>
		<li>Once the tube is advanced, stabilize it and carefully remove the stylet.</li>
		<li>Look for condensation inside the tube and feel for exhaled air at the tube&#39;s opening.</li>
		<li>Inflate the tube&#39;s cuff with air using a syringe until the leak around the tube is sealed.</li>
		<li>Connect a capnograph; the presence of a regular EtCO2 waveform confirms tracheal placement.</li>
		<li>Tie the tube to a bite block and firmly secure the assembly to the mandible or maxilla using tape.</li>
		<li>Connect the endotracheal tube to the anesthesia machine circuit. After the endotracheal intubation, transfer the animal to the operating room.</li>
	</ol>
	</li>
	<li>Muscle relaxant: After an IV bolus of 0.5 mg/kg atracurium, maintain the infusion at 5-10 &#181;g/kg/min. 
	NOTE: Mechanical ventilation is required following atracurium. Typical settings (juvenile swine): volume-controlled ventilation, VT 8&#8211;10 mL/kg, RR 12&#8211;18/min, PEEP 5 cmH2O, FiO2 0.4&#8211;0.6; adjust to maintain EtCO2&#160;35&#8211;45 mmHg and SpO2 &#62;95%.</li>
	<li>Maintenance anesthesia: Administer inhaled isoflurane at 2-3%, and maintain with dexmedetomidine 0.5&#8211;2.0 &#181;g/kg/h IV infusion (titrate to effect) and propofol 1-2 mg/kg/h. Use Succinylcholine 2 mg/kg as a muscle relaxant (pig is not sensitive to cis-benzene).</li>
	<li>Perform an anterior vena cava puncture to monitor central venous pressure (CVP).
	<ol>
		<li>Palpate the jugular groove between the anterior border of the sternocleidomastoid muscle and the trachea.</li>
		<li>Make a 3-4 cm longitudinal incision at the junction of the upper and middle thirds of the line connecting the mandibular angle to the manubrium sterni.</li>
		<li>Sharply incise the skin and subcutaneous fascia in layers.</li>
		<li>Perform blunt dissection through the platysma muscle to expose the carotid sheath.</li>
		<li>Mobilize a 1-2 cm segment of the jugular vein using a peanut dissector.</li>
		<li>Pass two ligatures beneath the isolated vein segment (proximal ligature for traction; distal for permanent ligation).</li>
		<li>Perform a venotomy by making a V-shaped incision in the anterior venous wall between ligatures using iris scissors.</li>
		<li>Insert the catheter bevel-down under direct visualization to ensure intraluminal placement.</li>
		<li>Advance the catheter 15-20 cm cephalad until reaching the superior vena cava (SVC).</li>
		<li>Confirm the placement by aspirating dark venous blood.</li>
		<li>Suture the fixation wing to subcutaneous tissue with 3-0 silk.</li>
		<li>Close the wound in layers (fascia: absorbable suture; skin: interrupted non-absorbable).</li>
		<li>CVP Monitoring setup: Connect in the following order one after another: catheter, 3-way stopcock, pressure transducer, monitor.</li>
		<li>Zero the transducer at the level of the sternal Angle and initiate continuous CVP waveform monitoring.</li>
	</ol>
	</li>
	<li>Connect the 3-lead electrocardiogram and detect the electrocardiogram during the whole process.</li>
	<li>Also monitor SpO2&#160;(pulse oximetry), EtCO2&#160;(capnography), and core temperature (rectal or esophageal probe). Document parameters at least every 5&#8211;10 min during induction/critical phases and every 10&#8211;15 min thereafter. Maintain temperature at 37.0&#8211;38.5 &#176;C using forced-air warming blanket/circulating warm-water pad</li>
	<li>Establish femoral artery access for blood pressure measurement when necessary.
	<ol>
		<li>Locate the femoral arterial pulse approximately 2-3 cm below the midpoint of the line connecting the anterior superior iliac spine and pubic tubercle.</li>
		<li>Make a 4-5 cm longitudinal incision along the axis of the femoral arterial pulse.</li>
		<li>Incise the skin and subcutaneous fat, and perform blunt dissection through the fascia.</li>
		<li>Incise the femoral sheath to expose the femoral artery and mobilize a 2-3 cm segment of the femoral artery.</li>
		<li>Apply microvascular clamps proximally and distally.</li>
		<li>Create a transverse arteriotomy (50% of arterial circumference).</li>
		<li>Insert the catheter bevel-up at 30&#176;.</li>
		<li>Advance the catheter 8-10 cm toward the aorta.</li>
		<li>Confirm pulsatile flow of bright red blood.</li>
		<li>Suture the catheter fixation wing to the deep fascia using 5-0 Prolene suture.</li>
		<li>Close the wound in layers.</li>
		<li>Connect in the following order one after another: the catheter, 3-way stopcock, pressure transducer, monitor.</li>
		<li>Position the transducer at the level of the right atrium (4th intercostal space/midaxillary line).</li>
		<li>Perform zero calibration and initiate continuous pressure monitoring.</li>
	</ol>
	</li>
</ol>
2. LVAD implantation
<ol>
	<li>Preoperative aseptic skin preparation: clip widely, then scrub the field with chlorhexidine (or povidone-iodine) alternating with 70% alcohol &#215;3; apply sterile drapes. Change gloves/drapes if contaminated during the procedure. Perform a median thoracotomy in the supine position; suspend the pericardium and fix it to expose the heart.</li>
	<li>Heparinization: Administer Sodium Heparin Injection (100 U/kg) via central venous catheter. 3-5 min after injection, draw an arterial blood sample to measure the Activated Clotting Time (ACT). The ACT value must reach and be maintained at &#62; 480 s before initiating cardiopulmonary bypass (CPB) establishment.</li>
	<li>Cardiopulmonary bypass establishment
	<ol>
		<li>After connecting the cardiopulmonary bypass (CPB) circuit tubing, prime the system with the prepared priming solution (Sodium lactate Ringer&#39;s injection: Tetraspan 6% = 2:1, with added heparin: 2 - 4 IU heparin per 1 mL of total priming volume, sodium bicarbonate: 5 - 10 mmol per 1000 mL of priming volume, etc.).</li>
		<li>Place two purse-string sutures using pledgeted double-armed sutures at the selected cannulation site on the anterior wall of the aorta.</li>
		<li>Incise the center of the purse-string sutures. Insert a 22 F aortic cannula. Securely tie the purse-string sutures and fix the cannula, ensuring hemostasis.</li>
		<li>Connect the distal end of the cannula to the arterial line of the cardiopulmonary bypass machine.</li>
		<li>Identify the cannulation site at the right atrial appendage, and place a single pledgeted double-armed suture at the selected site.</li>
		<li>Incise the center of the purse-string suture with a scalpel blade. Insert a 26 F venous cannula and snug the purse-string suture around the cannula.</li>
		<li>Connect the cannula to the venous line of the cardiopulmonary bypass machine.</li>
	</ol>
	</li>
	<li>Pass the LVAD signal line through the subcutaneous tunnel from the back and connect it to the controller to prevent the pig from rubbing against the signal line and causing it to fall off after waking up later.
	<ol>
		<li>Mark the point where the signal line exits on the side of the pig&#39;s back at a position 3-5 cm away from the center line.</li>
		<li>Make an incision in the skin to create a point. Use vascular forceps to perform a blunt dissection of the subcutaneous tissue towards the left fourth intercostal space.</li>
		<li>Use metal tips to guide the signal wires through the subcutaneous tunnel. The outer end is connected to the controller, and the inner end is used as a backup to connect the LVAD.</li>
	</ol>
	</li>
	<li>Determine the position and direction of the mitral valve with ultrasound.
	<ol>
		<li>Gently position a sterile high-frequency linear array probe (7-10 MHz) over the nonvascular zone of the left ventricular apex to acquire key imaging planes.</li>
		<li>In the left ventricular long-axis view, localize the coaptation zone between the anterior mitral leaflet (segments A2/A3) and posterior mitral leaflet (segments P2/P3).</li>
		<li>In the modified apical four-chamber view, adjust probe angulation along the right ventricular free wall to visualize the entire mitral valve coaptation line.</li>
		<li>Freeze the image at mid-diastole, then measure the perpendicular distance from the midpoint of the anterior mitral leaflet free edge to the center of the proposed LVAD inflow cannula site (&#62; 15 mm).</li>
	</ol>
	</li>
	<li>Ensure the LVAD is successfully connected to the artificial blood vessel in advance. Testing in normal saline ensures that the LVAD is functioning properly and there is no leakage in the artificial blood vessel.</li>
	<li>Use a sterile surgical marker to draw the fixed position of the apical ring at the apex of the heart.</li>
	<li>Fix the top ring at the apex position using a 5-0 suture thread with a gasket.</li>
	<li>Remove the myocardium within the parietal ring using an apical punch and trim with tweezers and scissors to prevent fragments from falling into the cardiac cavity.</li>
	<li>Exhaust all the air from the LVAD pump by placing the LVAD in normal saline and running it slowly and filling it with normal saline.</li>
	<li>Block the artificial blood to prevent air from entering.</li>
	<li>Insert the LVAD pump head into the top ring and ensure that the pump head enters the cardiac cavity. Fasten the lock tightly and remove the top ring clamp.</li>
	<li>Determine the appropriate length of the artificial blood vessel (diameter: 8 mm) from the LVAD pump head to the ascending aorta (15-20 cm).</li>
	<li>Place a partial occlusion clamp anterolaterally on the ascending aorta.</li>
	<li>Make an initial stab incision with a scalpel blade 1 cm distal to the coronary ostia.</li>
	<li>Extend the incision into an oval shape using scissors.</li>
	<li>Cut out an oblique opening (about 30&#176;) and anastomose the end to the ascending aorta to avoid distortion of the artificial blood vessel.
	<ol>
		<li>Posterior wall (6 o&#39;clock position): Place a pledgeted suture.</li>
		<li>Anterior wall (12 o&#39;clock position): Place a simple interrupted suture.</li>
		<li>Complete the remaining circumference with continuous suturing and secure the anastomosis with surgical knots. 
		NOTE: Allow 10% extra length in the vascular graft to prevent excessive tension and ensure the graft remains untwisted and unkinked throughout its course.</li>
	</ol>
	</li>
	<li>Check for any bleeding and further repair and suture.</li>
	<li>Place the ultrasound probe on the surface of the right atrium and conduct an ultrasound examination to observe the position of the LVAD pump head to confirm that the pump position was correct (the inlet port of the LVAD is directly facing the tricuspid valve).</li>
	<li>Program the LVAD controller to achieve target rotational speed (rpm) and flow rate: Adjust the appropriate rotational speed and flow rate according to the pig&#39;s body weight and cardiac output. Gradually increase the flow rate starting from 1.0 L/min, and maintain the blood pressure stable.</li>
	<li>Place the ultrasound probe on the ascending aorta to examine the blood flow. Ensure that the blood flow through the artificial vessel is smooth and that there is no significant turbulence in the aorta.</li>
	<li>Embed a drainage tube in each of the left and right spaces of the heart, and connect an external negative pressure suction bottle.</li>
	<li>Align the sternum and close the chest layer by layer.
	<ol>
		<li>Pass five 5-0 stainless steel sternal wires through the sternum using an 18 G needle guide, with one wire per intercostal space. Twist the wires sequentially and tightly from the xiphoid toward the cephalad direction.</li>
		<li>Approximate the pectoralis major muscle and fascia with a continuous 3-0 Vicryl suture.</li>
		<li>Close the subcutaneous tissue with a buried continuous 2-0 Monocryl suture.</li>
		<li>Reapproximate the skin using interrupted vertical mattress sutures of 4-0 Nylon.</li>
		<li>Disinfect the incision site with povidone-iodine solution according to aseptic technique.</li>
	</ol>
	</li>
</ol>
3. Postoperative care
<ol>
	<li>After LVAD implantation surgery, transfer the pig to the ICU for monitoring. Daily record the intake and output, including blood pressure and LVAD parameters. Anesthetize the pig with intravenous infusion of propofol and regulate the administration of vasoactive agents (Dopamine, isoproterenol, norepinephrine) to keep the hemodynamics stable for the first postoperative days. 
	NOTE: Provide thermal support and monitor temperature until fully recovered. Provide IV fluids (balanced crystalloids, e.g., 2&#8211;5 mL/kg/h initially, then titrate to hemodynamics/urine output/labs). Record water/feed intake daily and resume feeding as soon as awake; consider supplemental feeding per facility SOP if intake decreases. Clarify sedation/anesthesia (propofol infusion) is used only as clinically needed for early hemodynamic control/ventilator tolerance and discontinued once stable.</li>
	<li>Add opioid for major surgery: buprenorphine 0.01&#8211;0.02 mg/kg IM q8&#8211;12 h for 48&#8211;72 h, PLUS meloxicam as currently described (0.4 mg/kg SC q24 h for 0&#8211;72 h; 0.2 mg/kg PO q24 h for 72 h&#8211;7 d). Add pain assessment at least 2&#8211;3&#215;/day using behavioral/pain scoring and rescue analgesia criteria (additional opioid per veterinarian if score exceeds threshold).</li>
	<li>Use vasoactive agents and regulate the suitable LVAD flow (1/3-1/2 of normal cardiac output) to maintain normal blood flow dynamics in pigs. 
	NOTE: Pay attention to observing the LVAD signal lines and avoid being trampled or tangled by pigs.</li>
	<li>Present cardiac ultrasound on the postoperative first day, third day, seventh day, second week, and per week once. When there is almost no liquid around the heart, remove the drainage tubes.</li>
	<li>Postoperative anticoagulation regimen: Draw arterial blood using a 5 mL syringe from the vein catheter for ACT and international normalized ratio (INR) monitoring. For the first three days, administer intravenous infusion of heparin to maintain ACT at around 150-200 s. Starting from the third day, ensure the pig takes warfarin (0.15-0.2 mg/kg/d) orally, maintaining INR between 1.5 and 2. Discontinue heparin when the INR reaches 1.5.</li>
	<li>Postoperative anti-infection treatment plan: Administer cefazolin (25 mg/kg, q8h) for 5-7 days. Inspect incision and catheter sites daily for infection; change dressings per SOP; define criteria for veterinary intervention (fever, discharge, swelling, erythema).</li>
	<li>Postoperative LVAD control and data collection: Since a wired LVAD control system is being used, the signal lines exit from the back of the pig and connect to the monitor computer. Therefore, after the surgery, ensure the signal lines exit from above the cage and remain slack for long-term control and data collection. This is to prevent the signal lines from coming off due to the pig&#39;s movement.</li>
</ol>

<ol><li>Nickel, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Deactivation+of+LVAD+support+for+myocardial+recovery-surgical+perspectives%5BTitle%5D)+AND+%22J+Heart+Lung+Transplant%22%5BJournal%5D)">Deactivation of LVAD support for myocardial recovery-surgical perspectives.</a> J Heart Lung Transplant. 43 (9), 1489-1500 (2024).</li>
<li>Burkhoff, D., Topkara, V. K., Sayer, G., Uriel, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Reverse+remodeling+with+left+ventricular+assist+devices%5BTitle%5D)+AND+%22Circ+Res%22%5BJournal%5D)">Reverse remodeling with left ventricular assist devices.</a> Circ Res. 128 (10), 1594-1612 (2021).</li>
<li>Burkhoff, D., Klotz, S., Mancini, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((LVAD-induced+reverse+remodeling%3A+basic+and+clinical+implications+for+myocardial+recovery%5BTitle%5D)+AND+%22J+Card+Fail%22%5BJournal%5D)">LVAD-induced reverse remodeling: basic and clinical implications for myocardial recovery.</a> J Card Fail. 12 (3), 227-239 (2006).</li>
<li>Meissner, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Intra-aortic+band+impairs+transapical+device+implantation+in+a+pig%3A+a+case+report%5BTitle%5D)+AND+%22BMC+Vet+Res%22%5BJournal%5D)">Intra-aortic band impairs transapical device implantation in a pig: a case report.</a> BMC Vet Res. 19 (1), 212(2023).</li>
<li>Sakota, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Left+ventricular+assist+device+mode%3A+co-pulse+left+ventricular+unloading+in+a+working+mode+of+ex+vivo+heart+perfusion%5BTitle%5D)+AND+%22J+Heart+Lung+Transplant%22%5BJournal%5D)">Left ventricular assist device mode: co-pulse left ventricular unloading in a working mode of ex vivo heart perfusion.</a> J Heart Lung Transplant. 42 (6), 707-715 (2023).</li>
<li>Watanabe, K., Shih, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Update+of+pediatric+heart+failure%5BTitle%5D)+AND+%22Pediatr+Clin+North+Am%22%5BJournal%5D)">Update of pediatric heart failure.</a> Pediatr Clin North Am. 67 (5), 889-901 (2020).</li>
<li>Howard, T. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Leadless+pacemaker+implantation+in+an+adolescent+with+durable+LVAD+support%5BTitle%5D)+AND+%22Pediatr+Cardiol%22%5BJournal%5D)">Leadless pacemaker implantation in an adolescent with durable LVAD support.</a> Pediatr Cardiol. , (2025).</li>
<li>Schweiger, M., Miera, O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Not+little+adults%3A+outcomes+in+pediatric+intracorporeal+LVAD+patients%5BTitle%5D)+AND+%22J+Heart+Lung+Transplant%22%5BJournal%5D)">Not little adults: outcomes in pediatric intracorporeal LVAD patients.</a> J Heart Lung Transplant. 43 (1), 182-183 (2024).</li>
<li>Almond, C. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((A+prospective+multicenter+feasibility+study+of+a+miniaturized+implantable+continuous+flow+ventricular+assist+device+in+smaller+children+with+heart+failure%5BTitle%5D)+AND+%22J+Heart+Lung+Transplant%22%5BJournal%5D)">A prospective multicenter feasibility study of a miniaturized implantable continuous flow ventricular assist device in smaller children with heart failure.</a> J Heart Lung Transplant. 43 (6), 889-900 (2024).</li>
<li>Beltramo, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Validation+of+an+ultrasound+cardiac+output+monitor+as+a+bedside+tool+for+pediatric+patients%5BTitle%5D)+AND+%22Pediatr+Cardiol%22%5BJournal%5D)">Validation of an ultrasound cardiac output monitor as a bedside tool for pediatric patients.</a> Pediatr Cardiol. 37 (1), 177-183 (2016).</li>
<li>Pagani, F. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Concomitant+surgical+procedures+and+aspirin+avoidance+with+left+ventricular+assist+device+therapy%5BTitle%5D)+AND+%22JACC+Heart+Fail%22%5BJournal%5D)">Concomitant surgical procedures and aspirin avoidance with left ventricular assist device therapy.</a> JACC Heart Fail. 13 (7), 1-13 (2025).</li>
<li>Lilja, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Detection+of+inflow+obstruction+in+left+ventricular+assist+devices+by+accelerometer%3A+a+porcine+model+study%5BTitle%5D)+AND+%22J+Heart+Lung+Transplant%22%5BJournal%5D)">Detection of inflow obstruction in left ventricular assist devices by accelerometer: a porcine model study.</a> J Heart Lung Transplant. 42 (8), 1005-1014 (2023).</li>
<li>Santiago, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Design+and+execution+of+a+verification%2C+validation%2C+and+uncertainty+quantification+plan+for+a+numerical+model+of+left+ventricular+flow+after+LVAD+implantation%5BTitle%5D)+AND+%22PLoS+Comput+Biol%22%5BJournal%5D)">Design and execution of a verification, validation, and uncertainty quantification plan for a numerical model of left ventricular flow after LVAD implantation.</a> PLoS Comput Biol. 18 (6), e1010141(2022).</li>
<li>De Lazzari, C., Ferrari, G., Mimmo, R., Tosti, G., Ambrosi, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((A+desk-top+computer+model+of+the+circulatory+system+for+heart+assistance+simulation%3A+effect+of+an+LVAD+on+energetic+relationships+inside+the+left+ventricle%5BTitle%5D)+AND+%22Med+Eng+Phys%22%5BJournal%5D)">A desk-top computer model of the circulatory system for heart assistance simulation: effect of an LVAD on energetic relationships inside the left ventricle.</a> Med Eng Phys. 16 (2), 97-103 (1994).</li>
<li>Yu, X. Y., Shi, J. W., Zang, Y. R., Zhang, J. M., Liu, Z. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Factors+influencing+the+functional+status+of+aortic+valve+in+ovine+models+supported+by+continuous-flow+left+ventricular+assist+device%5BTitle%5D)+AND+%22Artif+Organs%22%5BJournal%5D)">Factors influencing the functional status of aortic valve in ovine models supported by continuous-flow left ventricular assist device.</a> Artif Organs. 46 (7), 1334-1345 (2022).</li>
</ol>

Authors have no conflicts of interest to declare.

The young landrace LVAD implantation model supplied a method to research the detailed mechanism of LVAD resulting in reverse remodeling. It can be used to disclose the continuous dynamic changes of the myocardium after the implantation of an LVAD at different time points. In addition, myocardial biopsy is available to track the myocardial changes of the same animal, which could reduce the usage of animals. What's more, the 3-month-old young landrace is of the same age as children, which is an excellent model for child LV...

LVAD therapy improves survival in heart failure patients and serves as a bridge to heart transplantation. LVAD has been used in adults for decades, which is thought to restore cardiac function by promoting reverse myocardial remodeling1. The past research focused on adult LVAD implantation patients2. However, the detailed reverse remodeling molecular mechanism for LVAD treatment was still unclear in kids3. Therefore, a good model for LVAD treatment mechanism research resulting in reverse remodeling is necessary. Although mouse models are widely used in drug evaluation and device development for cardiovascular diseases, the immune system, myocardial contractility, hemodynamics, and metabolism of mice are quite different from those of humans. In addition, the resting heart rate of mice can reach as high as 500-600 beats per min, which is 6-10 times that of humans. It is too fast to implant ventricular assist devices. Moreover, the size of the left ventricle and blood vessels in mice is very small. It is extremely difficult to design and implant pipes that are sufficiently thin, flexible, biocompatible, and capable of ensuring adequate flow and low resistance. Therefore, there is a need to develop animal models that are more representative of humans. In terms of the circulation system, pigs are very similar to humans, which could be a good model animal for human circulation system disease or instrument implantation research, and pig models are widely used in preclinical translational studies of ventricular assist devices4,5. Our protocol established a new pediatric LVAD implantation model in young juvenile landrace swine.
Additionally, pediatric heart failure (PHF) affects 0.87-7.4 per 100,000 children6. Although heart transplantation (HT) is the gold standard method to treat HF, some children can't get a donor heart immediately. So, pediatric LVAD implantation is needed for the life support of HF children. LVAD utilization is increasing in pediatrics, but these patients are often complex and may require treatment of atrioventricular block7. In addition, there is no suitable pediatric LVAD for HF children, and the past clinical results showed that the rates of major bleeding, stroke rates, infection, and renal dysfunction were higher than adults8. In previous short-term clinical trials, the use of pediatric LVADs has led to problems such as ischemic stroke and severe arrhythmias, which indicate that pediatric LVADs need to be further optimized9. Therefore, it is necessary to build a child LVAD implantation model. It could be an important model for new LVAD testing or reverse remodeling mechanism research. Young landrace pigs are relatively small in size, with a heart weight of approximately 100 g, similar to that of children. They can be used to evaluate the safety and efficacy of implantable ventricular assist devices specifically designed for children. Therefore, young landrace is a suitable strain for child LVAD implantation research.
In this article, we provided a young landrace LVAD implantation model. It could be a suitable model to uncover the mechanism of LVAD reverse remodeling mechanism and evaluate the safety and effectiveness of pediatric LVAD implantation.

<table><tbody><tr><td>10-degree aortic cross-clamp</td><td>Sinoview</td><td>CP40431-19</td><td>Aortic occlusion</td></tr><tr><td>10-degree aortic cross-clamp</td><td>Sinoview</td><td>CP40431-19</td><td>Aortic occlusion</td></tr><tr><td>30-degree arch branch vascular clamp</td><td>Sinoview</td><td>CP40432-19</td><td></td></tr><tr><td>45-degree aortic cross-clamp</td><td>Sinoview</td><td>CP40044-18</td><td></td></tr><tr><td>ACT-K Cartridge</td><td>Abbott</td><td>03P74-25</td><td>ACT monitoring</td></tr><tr><td>ACT-LR Test Tubes</td><td>Medtronic</td><td>809</td><td>ACT monitoring</td></tr><tr><td>Affinity Fusion Oxygenation System</td><td>Medtronic</td><td>BB841</td><td>Cardiopulmonary bypass</td></tr><tr><td>Anesthesia machine</td><td>Mindray</td><td>A9</td><td>Anesthesia and others</td></tr><tr><td>Apical Ring (Sewing Cuff)</td><td>Cor-Heart</td><td>-</td><td>Implanted component. Sutured to the cardiac apex to provide support and sealing for the pump connection to the heart.</td></tr><tr><td>Arterial cannula</td><td>Medtronic</td><td>18Fr</td><td>Cardiopulmonary bypass</td></tr><tr><td>Atracurium</td><td>Hengrui Pharmaceutical</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Atraumatic flat forceps</td><td>SureMed</td><td>GF04021-25</td><td></td></tr><tr><td>Atraumatic flat forceps</td><td>SureMed</td><td>GF04021-25</td><td></td></tr><tr><td>Balanced handle pen-style microsurgical forceps</td><td>Sinoview</td><td>FC12010-21</td><td></td></tr><tr><td>Juvenile Landrace Swine</td><td>Institute of Zoology, Chinese Academy of Sciences, Northern Large Animal Research Facility</td><td>-</td><td>Experimental animals</td></tr><tr><td>Blood gas analyzer</td><td>Ediagnosis</td><td>PT1000</td><td>Anesthesia and others</td></tr><tr><td>Cable Puller</td><td>Cor-Heart</td><td>-</td><td>Surgical accessory. Used during surgery to pull the percutaneous cable out of the body.</td></tr><tr><td>Cardiopulmonary bypass circuit</td><td>Medtronic</td><td>B-HL-159</td><td>Cardiopulmonary bypass</td></tr><tr><td>Central venous catheter</td><td>Baihe Medical</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Charger Base</td><td>Cor-Heart</td><td>-</td><td>External component. Charges the battery.</td></tr><tr><td>CoaguChek XS PT Test Strips</td><td>Roche</td><td>4015630936854&amp;nbsp;(EAN)</td><td>INR monitoring</td></tr><tr><td>Communication Adapter</td><td>Cor-Heart</td><td>-</td><td>Optional external component, reusable. Enables communication connection between the monitor and the controller.</td></tr><tr><td>Connector Protector</td><td>Cor-Heart</td><td>-</td><td>External component. Used to strengthen the connection between the percutaneous cable and the controller cable and prevent connector rotation/loosening.</td></tr><tr><td>Connector Seal Sleeve</td><td>Cor-Heart</td><td>-</td><td>Surgical accessory. Used during surgery to connect the cable puller to the percutaneous cable and ensure sealing integrity.</td></tr><tr><td>Controller</td><td>Cor-Heart</td><td>-</td><td>External component. Connects to and monitors pump operation, providing alarm functions for abnormalities.</td></tr><tr><td>Coring Knife</td><td>Cor-Heart</td><td>-</td><td>Surgical accessory. Used during surgery to create an opening in the cardiac apex.</td></tr><tr><td>Curved forceps</td><td>SureMed</td><td>GC01002-16</td><td></td></tr><tr><td>Curved forceps</td><td>SureMed</td><td>GC01002-12</td><td></td></tr><tr><td>Curved forceps</td><td>SureMed</td><td>GC01002-16</td><td></td></tr><tr><td>Disposable blood microembolus filter</td><td>Sansin</td><td>FAF-2</td><td>Cardiopulmonary bypass</td></tr><tr><td>Disposable blood reservoir filter</td><td>Sansin</td><td>FCR300K</td><td>Cardiopulmonary bypass</td></tr><tr><td>Disposable cardioplegia delivery system</td><td>Medtronic</td><td>XP41</td><td>Cardiopulmonary bypass</td></tr><tr><td>Dopamine</td><td>Jiuan Pharmaceutical</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Endotracheal tube</td><td>Yaxin Medicine</td><td>YS-0000</td><td>Anesthesia and others</td></tr><tr><td>Epinephrine</td><td>Jinyao Pharmaceutical</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Fine dissecting forceps</td><td>SureMed</td><td>GC01090-20</td><td></td></tr><tr><td>Fine dissection forceps</td><td>SureMed</td><td>GC01090-20</td><td></td></tr><tr><td>Heart-lung machine</td><td>LivaNova</td><td>S5</td><td>Cardiopulmonary bypass</td></tr><tr><td>Heparin</td><td>North China Pharmaceutical</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Ice bucket</td><td>SureMed</td><td>GQ13018-00D</td><td></td></tr><tr><td>Ice bucket</td><td>SureMed</td><td>GQ13018-00D</td><td></td></tr><tr><td>Infusion pump</td><td>Sino MDT</td><td>SN-C8</td><td>Anesthesia and others</td></tr><tr><td>INRatio PT/INR Test Strip</td><td>HemoSense</td><td>REF:0100071&amp;nbsp;</td><td>INR monitoring</td></tr><tr><td>Intravenous catheter</td><td>KDL</td><td>16G-26G</td><td>Anesthesia and others</td></tr><tr><td>Isoflurane</td><td>Lunan Pharmaceutical</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Isoproterenol</td><td>Harvest Pharmaceutical</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Lactated Ringer&#039;s Solution</td><td>Kelun Pharmaceutical</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Large basin</td><td>SureMed</td><td>GQ13033-00D</td><td></td></tr><tr><td>Large basin</td><td>SureMed</td><td>GQ13033-00D</td><td></td></tr><tr><td>Laryngoscope</td><td>Hanfeiyl</td><td>TD-C-III</td><td>Anesthesia and others</td></tr><tr><td>Lidocaine hydrochloride injection</td><td>Kelun Pharmaceutical co.,Ltd</td><td>H20057816</td><td></td></tr><tr><td>Magnesium sulfate for injection</td><td>Zdjt Pharmaceutical co.,Ltd</td><td>H20051792</td><td></td></tr><tr><td>Medical electric sternum saw</td><td>Jingdong xiji</td><td>HF-X01</td><td></td></tr><tr><td>Medical sternum saw, electric sternum saw</td><td>Jingdong xiji</td><td>HF-X01</td><td></td></tr><tr><td>Medium-sized sternum retractor</td><td>SureMed</td><td>GR04130-00</td><td></td></tr><tr><td>Modified St. Thomas Solution</td><td>Self-made</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Monitor/Computer</td><td>Cor-Heart</td><td>-</td><td>Optional external component, reusable. Connects to the controller and ventricular assist pump for setup and operation.</td></tr><tr><td>Multiparameter monitor</td><td>Mindray</td><td>Benoversion N17</td><td>Anesthesia and others</td></tr><tr><td>Needle passer for purse-string sutures</td><td>SureMed</td><td>GR04074-00</td><td></td></tr><tr><td>Norepinephrine</td><td>Harvest Pharmaceutical</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Outflow Cannula</td><td>Cor-Heart</td><td>-</td><td>Implanted component. Fixedly connects to the artificial vessel and provides protection for it.</td></tr><tr><td>PCL ACT Test Cartridge</td><td>Instrumentation Laboratory</td><td>257</td><td></td></tr><tr><td>Pediatric sternum retractor</td><td>SureMed</td><td>GR04114-00</td><td></td></tr><tr><td>Potassium chloride injection</td><td>Kelun Pharmaceutical co.,Ltd</td><td>H42021164</td><td></td></tr><tr><td>Power Adapter</td><td>Cor-Heart</td><td>-</td><td>External component. Provides mains power connection to the Left Ventricular Assist System.</td></tr><tr><td>Protamine Sulfate</td><td>Youcare Pharmaceutical</td><td>-</td><td></td></tr><tr><td>Purse-string suture introducer</td><td>SureMed</td><td>GR04074-00</td><td></td></tr><tr><td>Rechargeable Lithium Battery Pack</td><td>Cor-Heart</td><td>-</td><td>External component. Provides power to the Left Ventricular Assist System (LVAS).</td></tr><tr><td>Resano atraumatic magic forceps</td><td>Sinoview</td><td>FC25501-23S</td><td></td></tr><tr><td>Right-angle forceps</td><td>SureMed</td><td>GC01110-14</td><td></td></tr><tr><td>Right-angle forceps</td><td>SureMed</td><td>GC01089-18</td><td></td></tr><tr><td>Right-angled clamp</td><td>SureMed</td><td>GC01110-14</td><td></td></tr><tr><td>Right-angled clamp</td><td>SureMed</td><td>GC01089-18</td><td></td></tr><tr><td>Small basin</td><td>SureMed</td><td>-</td><td></td></tr><tr><td>Sodium bicarbonate injection</td><td>Kelun Pharmaceutical co.,Ltd</td><td>H20043739</td><td></td></tr><tr><td>Sodium Lactate Ringer&#039;s Injection</td><td>Zhejiang Tianrui Pharma</td><td>H20033783</td><td></td></tr><tr><td>Sternal retractor (medium size)</td><td>SureMed</td><td>GR04130-00</td><td></td></tr><tr><td>Straight forceps</td><td>SureMed</td><td>GC01001-12</td><td></td></tr><tr><td>Straight forceps</td><td>SureMed</td><td>GC01001-16</td><td></td></tr><tr><td>Straight forceps</td><td>SureMed</td><td>GC01001-12</td><td></td></tr><tr><td>Straight forceps</td><td>SureMed</td><td>GC01001-16</td><td></td></tr><tr><td>Suture 5-0 Prolene BB</td><td>Ethicon</td><td>-</td><td></td></tr><tr><td>Suture Prolene Blum 4-0 SH 36</td><td>Ethicon</td><td>-</td><td></td></tr><tr><td>Sutures 2-0 Prolene Blu M SH</td><td>Ethicon</td><td>-</td><td></td></tr><tr><td>Sutures BB 4-0 Prolene</td><td>Ethicon</td><td>-</td><td></td></tr><tr><td>Temperature probe</td><td>3M</td><td>-</td><td>Anesthesia and others</td></tr><tr><td>Tetraspan 6%</td><td>B. Braun</td><td>L6511 (Ecobag)</td><td></td></tr><tr><td>Tonsil forceps</td><td>SureMed</td><td>GC09009-20D</td><td></td></tr><tr><td>Tungsten carbide ring-handled needle holder</td><td>SureMed</td><td>GN01013-22K</td><td></td></tr><tr><td>Tungsten carbide ring-handled needle holder</td><td>SureMed</td><td>GN01013-22K</td><td></td></tr><tr><td>Tungsten carbide ring-handled needle holder</td><td>SureMed</td><td>GN01010-22K</td><td></td></tr><tr><td>Venous cannula</td><td>Medtronic</td><td>28Fr, 32Fr</td><td>Cardiopulmonary bypass</td></tr><tr><td>Ventilator</td><td>Mindray</td><td>SV300</td><td>Anesthesia and others</td></tr><tr><td>Ventricular Assist Pump</td><td>Cor-Heart</td><td>-</td><td>A kind of magnetic levitation centrifugal pump. Implanted component. Implanted in the heart to assist blood circulation.</td></tr></tbody></table>

implantation of left ventricular assist device (lvad) in juvenile landrace swine: a lvad implantation model of pediatric heart failure

Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure

A pediatric left ventricular assist device (LVAD) implantation model was established to simulate pediatric LVAD support and research the mechanism of heart reverse remodeling. Heart failure (HF) is a prevalent global cardiovascular disease. LVAD implantation is an essential method to treat HF. However, existing pediatric LVAD implantation models remain underdeveloped, and the mechanism of LVAD treatment resulting in ventricular reverse remodeling was unclear, especially among children, though there was a lot of research uncovering the possible target. Therefore, it's necessary to find out the mechanism, especially in children. A good model is the foundation for testing the function of a new pediatric LVAD and disclosing the key mechanism. We established a young landrace pig LVAD implantation model, which could be used to assume pediatric LVAD security and effectiveness. After the LVAD was implanted, the LVAD pump maintained stable and uninterrupted blood flow for over 1 month. Besides, the vital signs, including hemodynamics, were stable and within the ideal and normal ranges. This model accurately replicates hemodynamic conditions in clinical patients post-LVAD implantation. It could be used to trace the continuous changes after LVAD implantation. At the same time, it can be used to disclose the reactivity and safety of child LVAD implantation. This protocol is an easy and standard general process to build a uniformization model for child LVAD implantation research.

To establish the model of LVAD implantation for children, we used this protocol on 3-months-old young landrace, 33.8 kg, male, which gained 2.6 kg after 4 weeks of surgery. Landrace swine typically reach sexual maturity at approximately one year of age. Therefore, it's absolutely young swine. As Figure 1A shows, we completed the LVAD implantation surgery in accordance with the protocol. As the preoperative 12-lead electrocardiogram (ECG) result showed, the EC...

This article presents a protocol to implant the left ventricular assist device (LVAD) into a piglet. This model represents a potent way to study the LVAD implantation in children and reveal the mechanism of ventricular reverse remodeling in LVAD treatment.

A pediatric left ventricular assist device (LVAD) implantation model was established to simulate pediatric LVAD support and research the mechanism of ...

Our research establishes a juvenile pig model to study pediatric LVAD and heart reverse remodeling. A major challenge is the lack of a suitable animal model that represents a child's side and heart. To begin, make a three to four centimeter longitudinal incision at the junction of the upper and middle thirds of the line, connecting the mandibular angle to the manubrium sterni.After the jugular vein, perform anterior vena cava puncture to monitor the central venous pressure. Establish femoral artery access for blood pressure measurement when necessary. Now, perform a median thoracotomy in the supine position.Suspend the pericardium and fix it to expose the heart. Next, pass the LVAD signal line through the subcutaneous tunnel from the back and connect it to the controller to prevent the pig from rubbing against the signal line and causing it to fall off after waking up later. Then, determine the position and direction of the mitral valve with ultrasound.Use a sterile surgical marker to draw the fixed position of the apical ring at the apex of the heart. Now, using a 5-0 suture thread with a gasket, fix the top ring at the apex position. Then, remove the myocardium within the parietal ring using an apical punch and trim with tweezers and scissors to prevent fragments from falling into the cardiac cavity.Insert the LVAD pump head into the top ring, ensuring that the pump head enters the cardiac cavity. Fasten the lock tightly and remove the top ring clamp. Determine the appropriate length of the artificial blood vessel from the LVAD pump head to the ascending aorta.Then, cut out an oblique opening at about a 30 degree angle and anastomose the end to the ascending aorta to avoid distortion of the artificial blood vessel. Now, place the ultrasound probe on the ascending aorta to examine the blood flow. Ensure that the blood flow through the artificial vessel is smooth and that there is no significant turbulence in the aorta.Embed a drainage tube in each of the left and right spaces of the heart and connect an external negative pressure suction bottle. Finally, align the sternum and close the chest layer by layer. The left ventricular assist device implantation in a three-month old Landrace pig was successfully completed following the established protocol.The preoperative electrocardiogram showed a normal cardiac rhythm before surgery. Postoperative electrocardiogram results on the 3rd and 14th days showed no abnormalities compared with the preoperative result. The preoperative echocardiography revealed a left ventricular ejection fraction of 62%and a fractional shortening of 26%The LVAD pump head was confirmed intraoperatively to face directly toward the mitral valve.Postoperative echocardiography on the 14th day confirmed the LVAD pump head remained in place with normal ventricular wall motion and heart function. The left ventricle ejection fraction and fractional shortening remained within normal ranges throughout the 28-day postoperative period. Red blood cell count and hemoglobin decreased after surgery, but stabilized following transfusion.Platelet count and neutrophil percentage fluctuated within the first three postoperative days likely due to surgical trauma. Liver and kidney function markers temporarily increased after surgery, but returned to normal within three days. The LVAD maintained stable function with an average rotational speed of 3, 600 revolutions per minute and flow around two liters per minute post-implantation.Postoperative heart rate, systolic pressure, and diastolic pressure remained stable during continuous monitoring. We address the carotid gap for pediatrics model for safety and mechanical research. Our model use young mimic the heart size and of children.This model will help us develop safer, more effective ventricular assist devices for children.

implantation-left-ventricular-assist-device-lvad-juvenile-landrace

Research

JoVE Journal

Medicine

Here, we present a protocol to produce tachycardia-induced cardiomyopathy in swine. This model represents a potent way to study the hemodynamics of progressive chronic heart failure and the effects of applied treatment.

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine

We sought to establish a swine model of heart failure induced by left circumflex artery blockage and rapid pacing to test the effect and safety of intramyocardial administration of stem cells for cell-based therapies.

Establishing a Swine Model of Post-myocardial Infarction Heart Failure for Stem Cell Treatment

This protocol describes a juvenile porcine model of orthotopic left lung allotransplantation designed for use with ESLP research. Focus is made on anesthetic and surgical techniques, as well as critical steps and troubleshooting.

Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP

Right ventricular failure and functional tricuspid regurgitation are associated with left-sided heart disease and pulmonary hypertension, which contribute significantly to morbidity and mortality in patients. Establishing a chronic ovine model to study right ventricular failure and functional tricuspid regurgitation will help in understanding their mechanisms, progression, and possible treatments.

Chronic Ovine Model of Right Ventricular Failure and Functional Tricuspid Regurgitation

This protocol describes a neonatal porcine model of cardiopulmonary bypass (CPB), with circulatory and cardiac arrest as a tool for studying severe brain damage and other complications secondary to CPB.

Pediatric Animal Model of Extracorporeal Cardiopulmonary Resuscitation After Prolonged Circulatory Arrest

Here, we present a detailed visual protocol for executing the left atrial ligation (LAL) model in the avian embryo. The LAL model alters the intracardiac flow, which changes wall shear stress loading, mimicking hypoplastic left heart syndrome. An approach to overcome the challenges of this difficult microsurgery model is presented.

Left Atrial Ligation in the Avian Embryo as a Model for Altered Hemodynamic Loading During Early Vascular Development

This protocol presents the establishment and confirmation of a postnatal right ventricular volume overload (VO) model in mice with abdominal arteriovenous fistula (AVF), which can be applied to investigate how VO contributes to postnatal heart development.

Establishment and Confirmation of a Postnatal Right Ventricular Volume Overload Mouse Model

This work presents an animal model of endothelial-to-mesenchymal transition-induced fibrosis, as seen in congenital cardiac defects such as critical aortic stenosis or hypoplastic left heart syndrome, which allows for detailed histological tissue evaluation, the identification of regulatory signaling pathways, and the testing of treatment options.

A Neonatal Heterotopic Rat Heart Transplantation Model for the Study of Endothelial-to-Mesenchymal Transition

This protocol describes a minimally invasive surgical procedure for ascending aortic banding in swine.

A Minimally Invasive Model of Aortic Stenosis in Swine

Dual-chamber implantable cardioverter-defibrillators (ICDs) may improve detection of atrial fibrillation as well as differentiation of tachycardias. However, this advantage is undermined by complications associated with the second electrode, which is required in conventional dual chamber devices.  Therefore, BIOTRONIK has developed a new electrode called the LinoxSMART S DX that, when used in conjunction with the Lumax DX ICD, offers dual-chamber detection without the risks associated with the...

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and  Ease of Implantation

Learn LVAD implantation in juvenile Landrace swine to study pediatric heart failure and ventricular reverse remodeling. This model supports development of safer cardiac assist devices for children.

Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure (Video) | JoVE Journal

Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure

Explore More Videos