Safety and feasibility of left atrial appendage inversion in swine: A proof-of-concept study for potential therapy to prevent embolic stroke
Objective: Left atrial appendage (LAA) occlusion or exclusion has been used in patients with atrial fibrillation to prevent stroke, but the techniques and devices have shortcomings. This study aims to validate the safety and feasibility of a novel LAA inversion procedure.Methods: LAA inversion proce...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2023.1011121/full |
| _version_ | 1797904945703288832 |
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| author | Yanmin Wang Mengjun Wang Xiaomei Guo Xiaomei Guo Ling Han Ghassan Kassab Ghassan Kassab |
| author_facet | Yanmin Wang Mengjun Wang Xiaomei Guo Xiaomei Guo Ling Han Ghassan Kassab Ghassan Kassab |
| author_sort | Yanmin Wang |
| collection | DOAJ |
| description | Objective: Left atrial appendage (LAA) occlusion or exclusion has been used in patients with atrial fibrillation to prevent stroke, but the techniques and devices have shortcomings. This study aims to validate the safety and feasibility of a novel LAA inversion procedure.Methods: LAA inversion procedures were done in six pigs. Before the procedure and at 8 weeks postoperatively, heart rate, blood pressure, and electrocardiogram (ECG) were recorded. The serum concentration of atrial natriuretic peptide (ANP) was measured. The LAA was observed and measured by transesophageal echocardiogram (TEE) and intracardiac echocardiogram (ICE). At 8 weeks after LAA inversion, the animal was euthanized. The heart was collected for morphology and histology, including hematoxylin-eosin, Masson trichrome, and immunofluorescence staining.Results: TEE and ICE showed that LAA was inverted, and the inversion was maintained during the 8-week study duration. Food intake, body weight gain, heart rate, blood pressure, ECG, and serum ANP level were comparable before and after the procedure. Morphology and histological staining showed that there was no obvious inflammation or thrombus. Tissue remodeling and fibrosis were observed at the LAA inverted site.Conclusion: The inversion of LAA effectively eliminates the dead space of LAA and thus may reduce the risk of embolic stroke. The novel procedure is safe and feasible, but the efficacy in reducing embolization remains to be demonstrated in future studies. |
| first_indexed | 2024-04-10T09:57:05Z |
| format | Article |
| id | doaj.art-e3483aa375c94667acd3f86dd9ea20a8 |
| institution | Directory Open Access Journal |
| issn | 2296-4185 |
| language | English |
| last_indexed | 2024-04-10T09:57:05Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-e3483aa375c94667acd3f86dd9ea20a82023-02-16T12:22:22ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852023-02-011110.3389/fbioe.2023.10111211011121Safety and feasibility of left atrial appendage inversion in swine: A proof-of-concept study for potential therapy to prevent embolic strokeYanmin Wang0Mengjun Wang1Xiaomei Guo2Xiaomei Guo3Ling Han4Ghassan Kassab5Ghassan Kassab6California Medical Innovations Institute, San Diego, CA, United States3DT Holdings, LCC, San Diego, CA, United StatesCalifornia Medical Innovations Institute, San Diego, CA, United States3DT Holdings, LCC, San Diego, CA, United StatesCalifornia Medical Innovations Institute, San Diego, CA, United StatesCalifornia Medical Innovations Institute, San Diego, CA, United States3DT Holdings, LCC, San Diego, CA, United StatesObjective: Left atrial appendage (LAA) occlusion or exclusion has been used in patients with atrial fibrillation to prevent stroke, but the techniques and devices have shortcomings. This study aims to validate the safety and feasibility of a novel LAA inversion procedure.Methods: LAA inversion procedures were done in six pigs. Before the procedure and at 8 weeks postoperatively, heart rate, blood pressure, and electrocardiogram (ECG) were recorded. The serum concentration of atrial natriuretic peptide (ANP) was measured. The LAA was observed and measured by transesophageal echocardiogram (TEE) and intracardiac echocardiogram (ICE). At 8 weeks after LAA inversion, the animal was euthanized. The heart was collected for morphology and histology, including hematoxylin-eosin, Masson trichrome, and immunofluorescence staining.Results: TEE and ICE showed that LAA was inverted, and the inversion was maintained during the 8-week study duration. Food intake, body weight gain, heart rate, blood pressure, ECG, and serum ANP level were comparable before and after the procedure. Morphology and histological staining showed that there was no obvious inflammation or thrombus. Tissue remodeling and fibrosis were observed at the LAA inverted site.Conclusion: The inversion of LAA effectively eliminates the dead space of LAA and thus may reduce the risk of embolic stroke. The novel procedure is safe and feasible, but the efficacy in reducing embolization remains to be demonstrated in future studies.https://www.frontiersin.org/articles/10.3389/fbioe.2023.1011121/fullatrial fibrillationstrokeatrial appendageechocardiogramthoracotomy |
| spellingShingle | Yanmin Wang Mengjun Wang Xiaomei Guo Xiaomei Guo Ling Han Ghassan Kassab Ghassan Kassab Safety and feasibility of left atrial appendage inversion in swine: A proof-of-concept study for potential therapy to prevent embolic stroke Frontiers in Bioengineering and Biotechnology atrial fibrillation stroke atrial appendage echocardiogram thoracotomy |
| title | Safety and feasibility of left atrial appendage inversion in swine: A proof-of-concept study for potential therapy to prevent embolic stroke |
| title_full | Safety and feasibility of left atrial appendage inversion in swine: A proof-of-concept study for potential therapy to prevent embolic stroke |
| title_fullStr | Safety and feasibility of left atrial appendage inversion in swine: A proof-of-concept study for potential therapy to prevent embolic stroke |
| title_full_unstemmed | Safety and feasibility of left atrial appendage inversion in swine: A proof-of-concept study for potential therapy to prevent embolic stroke |
| title_short | Safety and feasibility of left atrial appendage inversion in swine: A proof-of-concept study for potential therapy to prevent embolic stroke |
| title_sort | safety and feasibility of left atrial appendage inversion in swine a proof of concept study for potential therapy to prevent embolic stroke |
| topic | atrial fibrillation stroke atrial appendage echocardiogram thoracotomy |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2023.1011121/full |
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