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目的:观察新型房间隔造口支架置入动物体内后的组织学反应,评价其可行性及安全性。方法:选用杂种实验犬8只,非体外循环下通过介入或外科方法进行创伤性房间隔造口术,直视下或经超声及透视下引导置入不同大小的新型房间隔造口支架,术后1周、2周、3周、4周、8周分别进行超声心动图检查了解造口通畅性,并处死动物进行大体解剖、光镜和电镜观察。结果:8只实验犬中例3犬因术中心室颤动死亡、例4犬术后12 h因心力衰竭死亡、例1犬造口支架置入右心房耳部;5只实验犬于房间隔成功置入造口支架,并存活1周以上,其中3只实验犬置入直径6 mm的造口支架,2只置入直径10 mm造口支架。超声心动图提示5只实验犬术后1周造口支架内全部通畅,术后2周发现例5犬造口支架内赘生物形成并造成支架内堵塞,术后3周、4周、8周超声发现另三只犬造口支架闭塞。术后3～8周的动物大体标本显示各组造口支架内填充以肉芽组织,支架表面均覆盖一层厚薄不等的、光滑的新生内膜组织,肺、肝、脾、肾脏等重要脏器均无细胞坏死、血栓栓塞现象。结论:动物实验证实了新型房间隔造口支架具有良好的经导管置入可行性,但造口通畅性不佳。造口支架局部结构还需进一步改进以减少组织增生和血栓形成。
OBJECTIVE: To observe the histological response of a new type of atrial septal stent into the body of an animal to evaluate its feasibility and safety. Methods: Eight hybrid experiment dogs were selected, and traumatic atrial septostomy was performed under the cardiopulmonary bypass by using interventional or surgical methods. The new type of atrial septal stent with different sizes was introduced under direct or ultrasonography and fluoroscopy Echocardiography was performed at 1 week, 2 weeks, 3 weeks, 4 weeks and 8 weeks respectively to observe the patency of the ostomy. Animals were sacrificed for gross anatomy, light and electron microscopy. Results: 8 dogs died of intraoperative ventricular fibrillation in 8 dogs, 4 dogs died of heart failure 12 h after operation. Example 1 Canine ostomy stent was implanted into the right atrium ear. 5 dogs were atrial septal success They were placed in a stoma stent and survived for more than 1 week. Three of the dogs were implanted with a 6 mm diameter stoma stent and two with a 10 mm diameter stoma stent. Echocardiography showed that 5 experimental dogs were completely unobstructed within one week after operation. Two weeks after operation, the formation of neoplasms in cases of canine stoma stent occlusion was found in 2 cases and the stent was blocked. After 3 weeks, 4 weeks and 8 weeks after operation, ultrasonography Three dogs were found occlusion of stoma. The gross specimens from 3 to 8 weeks postoperatively showed that granulation tissue was filled into the stoma of each group, and the surface of the stent was covered with a smooth layer of neointimal tissue with important dirty such as lung, liver, spleen and kidney No cell necrosis, thromboembolism phenomenon. Conclusion: Animal experiments confirmed the feasibility of the new atrial septal stent with good catheterization, but poor patency. The partial structure of the stoma needs further improvement to reduce tissue proliferation and thrombosis.