Comparative Review of Large Animal Models for Suitability of Proximal Aortic Endovascular Repair
Keywords:Aortic dissection, Endovascular, Ascending aorta, Animal models
The advent of thoracic endovascular aortic repair (TEVAR) heralds a paradigm shift in treating descending aortopathies. TEVAR is viewed as a potential option for ascending aortic dissection (AD) repair. Currently, TEVAR’s use in treating ascending aortopathies remains limited. Appropriate animal models are urgently needed to improve our understanding of the endovascular treatment of ascending ADs, also known as Stanford Type-A ADs. This narrative review provides a current literature summary on the subject, including the gross anatomical differences among adult porcine, ovine, and bovine species, compared with those of their human counterparts, as well as specific valvular and coronary vasculature measurement variances. An electronic search of Cochrane Library, PubMed, and Ovid Medline databases from January 1965 to June 2020 was performed. The search was limited to articles published in English. Twenty-three research papers were included in this review. Our findings revealed that whereas macroscopic anatomy remains grossly similar among these species, differences in valvular leaflet shape are present, with porcine and ovine models possessing anatomic characteristics that are comparable to their human counterparts. Inter-species differences concerning the anatomy of the ascending aorta have not been extensively studied, highlighting a literature gap. Conversely, multiple morphological studies have highlighted that porcine coronary vasculature is similar to that of humans. In conclusion, both porcine and ovine species are suitable as appropriate animal models for examining the feasibility of endovascular stent-grafts for ascending ADs. However, given the similarities in coronary and aortic valve anatomy with humans, porcine models are better suited for this purpose.
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