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journal article Oct 16, 2020

Pulmonary artery and lung parenchymal growth following early versus delayed stent interventions in a swine pulmonary artery stenosis model

Ryan Pewowaruk ORCID Joshua Hermsen Cody Johnson Alexandra Erdmann Kevin Pettit Scott Aesif J. Carter Ralphe Christopher J. François ORCID Alejandro Roldán‐Alzate Luke Lamers
Catheterization and Cardiovascular Interventions Vol. 96 No. 7 pp. 1454-1464 · Wiley
View at Publisher Save 10.1002/ccd.29326
Abstract
AbstractObjectivesCompare lung parenchymal and pulmonary artery (PA) growth and hemodynamics following early and delayed PA stent interventions for treatment of unilateral branch PA stenosis (PAS) in swine.BackgroundHow the pulmonary circulation remodels in response to different durations of hypoperfusion and how much growth and function can be recovered with catheter directed interventions at differing time periods of lung development is not understood.MethodsA total of 18 swine were assigned to four groups: Sham (n = 4), untreated left PAS (LPAS) (n = 4), early intervention (EI) (n = 5), and delayed intervention (DI) (n = 5). EI had left pulmonary artery (LPA) stenting at 5 weeks (6 kg) with redilation at 10 weeks. DI had stenting at 10 weeks. All underwent right heart catheterization, computed tomography, magnetic resonance imaging, and histology at 20 weeks (55 kg).ResultsEI decreased the extent of histologic changes in the left lung as DI had marked alveolar septal and bronchovascular abnormalities (p = .05 and p < .05 vs. sham) that were less prevalent in EI. EI also increased left lung volumes and alveolar counts compared to DI. EI and DI equally restored LPA pulsatility, R heart pressures, and distal LPA growth. EI and DI improved, but did not normalize LPA stenosis diameter (LPA/DAo ratio: Sham 1.27 ± 0.11 mm/mm, DI 0.88 ± 0.10 mm/mm, EI 1.01 ± 0.09 mm/mm) and pulmonary blood flow distributions (LPA‐flow%: Sham 52 ± 5%, LPAS 7 ± 2%, DI 44 ± 3%, EI 40 ± 2%).ConclusionIn this surgically created PAS model, EI was associated with improved lung parenchymal development compared to DI. Longer durations of L lung hypoperfusion did not detrimentally affect PA growth and R heart hemodynamics. Functional and anatomical discrepancies persist despite successful stent interventions that warrant additional investigation.
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Metrics
9
Citations
43
References
Details
Published
Oct 16, 2020
Vol/Issue
96(7)
Pages
1454-1464
License
View
Authors
R
Ryan Pewowaruk

Biomedical Engineering University of Wisconsin–Madison Madison Wisconsin USA

J
Joshua Hermsen

School of Medicine and Public Health University of Wisconsin–Madison Madison Wisconsin USA; Cardiovascular Surgery University of Wisconsin–Madison Madison Wisconsin USA

C
Cody Johnson

Radiology University of Wisconsin–Madison Madison Wisconsin USA

A
Alexandra Erdmann

School of Medicine and Public Health University of Wisconsin–Madison Madison Wisconsin USA

K
Kevin Pettit

School of Medicine and Public Health University of Wisconsin–Madison Madison Wisconsin USA

S
Scott Aesif

School of Medicine and Public Health University of Wisconsin–Madison Madison Wisconsin USA; Pathology University of Wisconsin–Madison Madison Wisconsin USA

J
J. Carter Ralphe

School of Medicine and Public Health University of Wisconsin–Madison Madison Wisconsin USA; Pediatrics, Division of Cardiology University of Wisconsin–Madison Madison Wisconsin USA

C
Christopher J. François

School of Medicine and Public Health University of Wisconsin–Madison Madison Wisconsin USA; Radiology University of Wisconsin–Madison Madison Wisconsin USA

A
Alejandro Roldán‐Alzate

Biomedical Engineering University of Wisconsin–Madison Madison Wisconsin USA; Radiology University of Wisconsin–Madison Madison Wisconsin USA; Mechanical Engineering University of Wisconsin–Madison Madison Wisconsin USA

L
Luke Lamers

School of Medicine and Public Health University of Wisconsin–Madison Madison Wisconsin USA; Pediatrics, Division of Cardiology University of Wisconsin–Madison Madison Wisconsin USA

Funding
National Heart, Lung, and Blood Institute Award: T32 HL 007936
National Center for Advancing Translational Sciences Award: UL1TR002373
Cite This Article
Ryan Pewowaruk, Joshua Hermsen, Cody Johnson, et al. (2020). Pulmonary artery and lung parenchymal growth following early versus delayed stent interventions in a swine pulmonary artery stenosis model. Catheterization and Cardiovascular Interventions, 96(7), 1454-1464. https://doi.org/10.1002/ccd.29326
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