A Clinically Relevant Swine Model of Chronic Myocardial Ischemia by Ameroid Constrictor Placement with Simultaneous...

Despite breakthroughs in medical and procedural therapies for the treatment of cardiovascular disease, the need for translational large animal models has persisted to investigate diagnostic tools and treatment strategies. Swine represent an impeccably accurate and appropriate model for human cardiovascular disease, as their cardiac anatomy and physiology closely resemble that of humans, as well as their metabolic and proteomic profile. The induction of chronic myocardial ischemia to an area of the myocardium by using an ameroid constrictor accurately and easily emulates the common pathophysiologic process of atherosclerosis development in humans and subsequent myocardial response. Ameroid constrictors have been widely studied over the last 50 years providing rigorous evidence for its use; furthermore, we have over two decades of experience in efficiently and uniformly conducting this procedure. An important step within this protocol is performing coronary blood flow mapping to determine the area of greatest ischemia and areas with no ischemia by injecting isotope-labeled microspheres. The ability to perform coronary blood flow mapping precludes the necessary and labor-intensive use of cardiac MRI or PET imaging for perfusion studies and determination of the ischemic territory. The goal of this publication is to detail the correct placement of an ameroid constrictor on the proximal LCx and subsequent coronary perfusion mapping.