An isolated beating pig heart platform for a comprehensive evaluation of intracardiac blood flow with 4D flow MRI: a feasibility study

Eva S. Peper (Corresponding author), Alberto M. Leopaldi, Sjoerd van Tuijl, Bram F. Coolen, Gustav J. Strijkers, Jan Baan, R. Nils Planken, Arend de Weger, Aart J. Nederveen, Henk A. Marquering, Pim van Ooij

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Abstract

Background: Cardiac magnetic resonance imaging (MRI) in large animals is cumbersome for various reasons, including ethical considerations, costs of housing and maintenance, and need for anaesthesia. Our primary purpose was to show the feasibility of an isolated beating pig heart model for four-dimensional (4D) flow MRI for investigating intracardiac blood flow patterns and flow parameters using slaughterhouse side products. In addition, the feasibility of evaluating transcatheter aortic valve replacement (TAVR) in the model was investigated. Methods: Seven slaughterhouse pig hearts were installed in the MRI-compatible isolated beating pig heart platform. First, Langendorff perfusion mode was established; then, the system switched to working mode, in which blood was actively pumped by the left ventricle. A pacemaker ensured a stable HR during 3-T MRI scanning. All hearts were submitted to human physiological conditions of cardiac output and stayed vital for several hours. Aortic flow was measured from which stroke volume, cardiac output, and regurgitation fraction were calculated. Results: 4D flow MRI acquisitions were successfully conducted in all hearts. Stroke volume was 31 ± 6 mL (mean ± standard deviation), cardiac output 3.3 ± 0.9 L/min, and regurgitation fraction 16% ± 9%. With 4D flow, intracardiac and coronary flow patterns could be visualised in all hearts. In addition, we could study valve function and regurgitation in two hearts after TAVR. Conclusions: The feasibility of 4D flow MRI in an isolated beating pig heart loaded to physiological conditions was demonstrated. The platform is promising for preclinical assessment of cardiac blood flow and function.

Original languageEnglish
Article number40
Number of pages10
JournalEuropean Radiology Experimental
Volume3
Issue number1
DOIs
Publication statusPublished - 1 Dec 2019

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Feasibility Studies
Swine
Magnetic Resonance Imaging
Cardiac Output
Abattoirs
Stroke Volume
Heart Ventricles
Anesthesia
Perfusion
Maintenance
Costs and Cost Analysis

Keywords

  • Heart valve diseases
  • Isolated heart preparation
  • Magnetic resonance imaging (4D flow)
  • Swine
  • Transcatheter aortic valve replacement

Cite this

Peper, Eva S. ; Leopaldi, Alberto M. ; van Tuijl, Sjoerd ; Coolen, Bram F. ; Strijkers, Gustav J. ; Baan, Jan ; Planken, R. Nils ; de Weger, Arend ; Nederveen, Aart J. ; Marquering, Henk A. ; van Ooij, Pim. / An isolated beating pig heart platform for a comprehensive evaluation of intracardiac blood flow with 4D flow MRI : a feasibility study. In: European Radiology Experimental. 2019 ; Vol. 3, No. 1.
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title = "An isolated beating pig heart platform for a comprehensive evaluation of intracardiac blood flow with 4D flow MRI: a feasibility study",
abstract = "Background: Cardiac magnetic resonance imaging (MRI) in large animals is cumbersome for various reasons, including ethical considerations, costs of housing and maintenance, and need for anaesthesia. Our primary purpose was to show the feasibility of an isolated beating pig heart model for four-dimensional (4D) flow MRI for investigating intracardiac blood flow patterns and flow parameters using slaughterhouse side products. In addition, the feasibility of evaluating transcatheter aortic valve replacement (TAVR) in the model was investigated. Methods: Seven slaughterhouse pig hearts were installed in the MRI-compatible isolated beating pig heart platform. First, Langendorff perfusion mode was established; then, the system switched to working mode, in which blood was actively pumped by the left ventricle. A pacemaker ensured a stable HR during 3-T MRI scanning. All hearts were submitted to human physiological conditions of cardiac output and stayed vital for several hours. Aortic flow was measured from which stroke volume, cardiac output, and regurgitation fraction were calculated. Results: 4D flow MRI acquisitions were successfully conducted in all hearts. Stroke volume was 31 ± 6 mL (mean ± standard deviation), cardiac output 3.3 ± 0.9 L/min, and regurgitation fraction 16{\%} ± 9{\%}. With 4D flow, intracardiac and coronary flow patterns could be visualised in all hearts. In addition, we could study valve function and regurgitation in two hearts after TAVR. Conclusions: The feasibility of 4D flow MRI in an isolated beating pig heart loaded to physiological conditions was demonstrated. The platform is promising for preclinical assessment of cardiac blood flow and function.",
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An isolated beating pig heart platform for a comprehensive evaluation of intracardiac blood flow with 4D flow MRI : a feasibility study. / Peper, Eva S. (Corresponding author); Leopaldi, Alberto M.; van Tuijl, Sjoerd; Coolen, Bram F.; Strijkers, Gustav J.; Baan, Jan; Planken, R. Nils; de Weger, Arend; Nederveen, Aart J.; Marquering, Henk A.; van Ooij, Pim.

In: European Radiology Experimental, Vol. 3, No. 1, 40, 01.12.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - An isolated beating pig heart platform for a comprehensive evaluation of intracardiac blood flow with 4D flow MRI

T2 - a feasibility study

AU - Peper, Eva S.

AU - Leopaldi, Alberto M.

AU - van Tuijl, Sjoerd

AU - Coolen, Bram F.

AU - Strijkers, Gustav J.

AU - Baan, Jan

AU - Planken, R. Nils

AU - de Weger, Arend

AU - Nederveen, Aart J.

AU - Marquering, Henk A.

AU - van Ooij, Pim

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Background: Cardiac magnetic resonance imaging (MRI) in large animals is cumbersome for various reasons, including ethical considerations, costs of housing and maintenance, and need for anaesthesia. Our primary purpose was to show the feasibility of an isolated beating pig heart model for four-dimensional (4D) flow MRI for investigating intracardiac blood flow patterns and flow parameters using slaughterhouse side products. In addition, the feasibility of evaluating transcatheter aortic valve replacement (TAVR) in the model was investigated. Methods: Seven slaughterhouse pig hearts were installed in the MRI-compatible isolated beating pig heart platform. First, Langendorff perfusion mode was established; then, the system switched to working mode, in which blood was actively pumped by the left ventricle. A pacemaker ensured a stable HR during 3-T MRI scanning. All hearts were submitted to human physiological conditions of cardiac output and stayed vital for several hours. Aortic flow was measured from which stroke volume, cardiac output, and regurgitation fraction were calculated. Results: 4D flow MRI acquisitions were successfully conducted in all hearts. Stroke volume was 31 ± 6 mL (mean ± standard deviation), cardiac output 3.3 ± 0.9 L/min, and regurgitation fraction 16% ± 9%. With 4D flow, intracardiac and coronary flow patterns could be visualised in all hearts. In addition, we could study valve function and regurgitation in two hearts after TAVR. Conclusions: The feasibility of 4D flow MRI in an isolated beating pig heart loaded to physiological conditions was demonstrated. The platform is promising for preclinical assessment of cardiac blood flow and function.

AB - Background: Cardiac magnetic resonance imaging (MRI) in large animals is cumbersome for various reasons, including ethical considerations, costs of housing and maintenance, and need for anaesthesia. Our primary purpose was to show the feasibility of an isolated beating pig heart model for four-dimensional (4D) flow MRI for investigating intracardiac blood flow patterns and flow parameters using slaughterhouse side products. In addition, the feasibility of evaluating transcatheter aortic valve replacement (TAVR) in the model was investigated. Methods: Seven slaughterhouse pig hearts were installed in the MRI-compatible isolated beating pig heart platform. First, Langendorff perfusion mode was established; then, the system switched to working mode, in which blood was actively pumped by the left ventricle. A pacemaker ensured a stable HR during 3-T MRI scanning. All hearts were submitted to human physiological conditions of cardiac output and stayed vital for several hours. Aortic flow was measured from which stroke volume, cardiac output, and regurgitation fraction were calculated. Results: 4D flow MRI acquisitions were successfully conducted in all hearts. Stroke volume was 31 ± 6 mL (mean ± standard deviation), cardiac output 3.3 ± 0.9 L/min, and regurgitation fraction 16% ± 9%. With 4D flow, intracardiac and coronary flow patterns could be visualised in all hearts. In addition, we could study valve function and regurgitation in two hearts after TAVR. Conclusions: The feasibility of 4D flow MRI in an isolated beating pig heart loaded to physiological conditions was demonstrated. The platform is promising for preclinical assessment of cardiac blood flow and function.

KW - Heart valve diseases

KW - Isolated heart preparation

KW - Magnetic resonance imaging (4D flow)

KW - Swine

KW - Transcatheter aortic valve replacement

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U2 - 10.1186/s41747-019-0114-5

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