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Bandagem reversível do tronco pulmonar: modelo experimental para preparo rápido do ventrículo pulmonar

A balloon catheter was developed to induce rapid "pulmonary ventricle"(RV) hypertrophy. The hearts of six young goats (avg. Wt: 5.3 kg) were submitted to increased afterload by the balloon catheter and assessed morphologically and by echocardiogram. Through a left thoracothomy, right ventricular outflow tract (RVOT) was exposed and baseline myocardial samples were harvested for electron and optical microscopic studies. The balloon catheter was then placed through the RVOT, in the lumen of the PA. After the convalescence postoperative period, RV training was begun by inflating the balloon with 0.5 ml of water and progressively reimflating with additional volumes (0.5 ml) at intervals of two days, causing progressive afterload. Serial echocardiographic assessments of the cardiac muscle mass were performed every one to two days. The animals were sacrificed after two to three weeks of RV training for morphologic evaluation of the heart. The external diameter of longitudinally sectioned myocytes was measured at the level of the nucleus, using an image analysis system (Quantimet-Leica). One micra thick sections from RV wall were examined at Philips 301 electron microscope to determine the volume density for mitochondria. The echocardiogram showed equality of the ventricles' thickness with a short interval of six to ten days of RV training. There was a significant increase in the diameter of the myocyte (p<0.001) and the nucleus (p<0.003) of RV. There was no change between the mean volume density for the mitochondria of the RV myocardial samples before and after RV training (p=0.385). This catheter permits the manipulation of the pulmonary artery lumen, allowing for the nonsurgical rapid prepare of the pulmonary ventrícle. It preserves the anatomical integrity of the pericardial cavity and contents in patients with TGA.

Balloon dilatation; Heart ventricle


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