Massimo Griselli

Riskhospitalet University Hospital

Title: First Isolated Single Ventricle Working Porcine Heart Model

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Biography

Massimo Griselli is a Cardiothoracic Surgeon with 25 years of experience specializing in congenital heart disease and thoracic transplantation. He has developed expertise in mechanical circulatory support, including advanced use of mechanical assist devices and ECMO. His clinical and academic focus is particularly centered on mechanical support strategies and transplantation for patients with single-ventricle physiology.

Abstract

Background : Isolated heart models constitute an important  substrate for reproducing physiological parameters  and testing pathological modifications and  therapies and are thus important pre-clinical tools. 

Single-ventricle (SV) congenital heart diseases  result usually with palliative ‘Fontan’ circulation  associated with morbidity and mortality despite  recent advances in the management of patients presenting with SV. 

Establishing a SV isolated heart model allows to investigate the physiology of an induced SV  cardiac function and reproducing the pathological  variations seen in humans. 

Possible therapies including modifying mechanical  circulatory supports (MCS); which in turn could be  tested on this model. 

Methods: York-X swine ranging from (70-90 kg) were utilized  due the similar characteristics with human heart  anatomies and physiology. 

Three recovered hearts were converted into SV  functioning organs via: (1) an atrial septal defect via  right atriotomy; (2) a ventricle septal defect via right  ventriculotomy; (3) the main pulmonary artery was  divided above the pulmonary valve and closed off SV hearts were connected to the apparatus and re-animated with heparinised pig blood and maintained  at temperature of 38ºC. 

The apparatus can be set in resting or working  mode conditions: one can tune preloads and  afterloads, and then collect hemodynamic data by  echocardiography, electrocardiography, and pressure sensors in all cardiac chambers. 

Results and Summary: An isolated-reanimated SV swine heart is easily  reproducible which shows a decrease in the cardiac function in time. This model can be used for preclinical  trials for testing therapies, particularly MCS devices. 

This SV pre-clinical model provide a tool to study cardiac  responses in resting and working conditions and to assess variations observed in SV patients and  their potential responses to different pharmacological,  electrical, and mechanical modifications. 

Absence of neuro-humoral response should be  considered, but reproducibility and accuracy of data make  this platform an elegant tool for cardiovascular research.