An acute animal model of aortic stenosis: initial attempts at leaflet modification

Percutaneous valve insertion is an emerging treatment for aortic stenosis (AS). To date, no large animal model exists that replicates human calcific AS; moreover, the absence of any valve pathology in currently available animal models prevents their use in any realistic assessment of percutaneous aortic valve therapy. Hence, the aim of the present study was to create an acute large animal model in which human calcific AS could be simulated.

Ten domestic swine underwent open-heart surgery utilizing cardiopulmonary bypass (CPB) and cardioplegic arrest. The aortic valve annulus and leaflets were injected with cyanoacrylate, after which epicardial echocardiography was used to assess the creation of AS. At the time of animal sacrifice, the hearts were harvested for gross and histopathological examination.

The leaflet and annular injections were performed successfully in all animals. Subsequently, seven animals were weaned from CPB and underwent post procedural echocardiographic evaluations, whereby the treated valves were harvested for gross and histological examination.

Cyanoacrylate can be injected into the porcine aortic valve and annulus to create a model that resembles human calcific AS in the acute setting. Additional long-term follow up studies must be conducted, however, before this model can be utilized in the development of percutaneous valve therapy.