A Double-Vessel Coronary Artery Bypass Grafting Porcine Model using Autologous Internal Mammary Veins

Hao Liu; Kai Xing; Wei Wang; Yuan Chang; Peiyuan Li; Xingchao Du; Jiangping Song; Xiao Chen

doi:10.3791/72141

A subscription to JoVE is required to view this content. Sign in or start your free trial.

Method Article

A Double-Vessel Coronary Artery Bypass Grafting Porcine Model using Autologous Internal Mammary Veins

190 views

⸱

DOI:

10.3791/72141

⸱

August 4th, 2026

Hao Liu¹^,²^,³ , Kai Xing¹^,²^,³ , Wei Wang¹ , Yuan Chang¹ , Peiyuan Li²^,³ , Xingchao Du¹^,²^,³ , Jiangping Song¹^,²^,³^,⁴^,⁵^,⁶ , Xiao Chen³^,⁷

¹Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, ²Beijing Key Laboratory of Xenotransplantation, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, ³State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, ⁴Department of Cardiac Surgery, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, ⁵Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences, ⁶Sanya Institute, Hainan Academy of Agricultural Sciences, ⁷Sanya Institute of China Agricultural University

Summary

This study successfully established three double-vessel coronary artery bypass grafting (CABG) porcine models using autologous internal mammary veins (IMVs). Because the native LAD and LCX were not ligated, this model theoretically preserves native coronary flow and may provide a technical platform for future studies of competitive-flow-related vein graft changes.

Abstract

The saphenous vein is one of the most commonly used conduits in coronary artery bypass grafting (CABG). However, the high long-term failure rate limits its clinical efficacy. Although hemodynamic factors are widely believed to drive vein graft failure (VGF), the exact underlying mechanisms remain unclear. Currently, the rat common carotid artery interposition vein graft model serves as the primary animal model for investigating VGF. However, substantial differences in cardiovascular physiology and hemodynamics between rats and humans limit the clinical translation of research findings. Pigs represent an ideal animal model for cardiovascular research because their cardiovascular anatomy and physiology closely resemble those of humans. In this study, three double-vessel CABG porcine models were established using autologous left and right internal mammary veins (IMVs), with one graft anastomosed from the aorta to the left anterior descending coronary artery (LAD) and the other from the aorta to the left circumflex coronary artery (LCX). Intraoperative ultrasonography confirmed flow in both IMV grafts in a representative animal, whereas postoperative computed tomography angiography (CTA) clearly demonstrated patency of the aorta-to-LAD IMV graft. Therefore, this study describes a technically feasible approach for establishing a large-animal CABG model for future studies of VGF.

Introduction

The saphenous vein remains one of the most important conduit sources for coronary artery bypass grafting (CABG) because of its availability, length, and technical versatility¹. However, saphenous vein grafts exhibit a failure rate of up to 61% at 10 years after CABG². This increases the need for repeat revascularization and is associated with a higher risk of in-hospital mortality. In recent years, accumulating evidence has suggested that hemodynamic factors, particularly competitive flow and abnormal wall shear stress, are major contributors to late graft failure³^,⁴