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Custom-made Clamp Facilitating Stabilization of Cuffs in Murine Heterotopic Cervical Heart Transplantation

Fukunaga, Naoto, MD1; Bissoondath, Ved1; Rao, Vivek, MD, PhD11

doi: 10.1097/TP.0000000000002582
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1 Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada.

Received 27 October 2018. Revision received 11 December 2018.

Accepted 13 December 2018.

The authors declare no funding or conflicts of interest.

N.F. participated in performing surgery, the writing of the paper, participated in research design. V.B. and V.R. were supervisors and reviewed the final manuscript before submission and participated in research design.

Correspondence: Vivek Rao, MD, PhD, Peter Munk Cardiac Centre, University Health Network, University of Toronto. (vivek.rao@uhn.ca).

Heterotopic cervical heart transplantation (HCHT) using the cuff technique has been used to investigate various issues in transplantation, although the use of abdominal transplant model is more common.1 The technical success of HCHT is dependent upon cuffing the vessels. We introduce our technique to facilitate placement of the cuffs.

Animal Care Committee has approved our research. With the recipient mouse anesthetized, a skin incision was made over the right side of the neck from the sternum to the lower mandible. Under microscopy, both the right external vein and carotid artery were bluntly dissected using a submandibular gland–preserving technique.2 The cuffs were stabilized with a needle holder fixed on a custom-made clamp (Figure 1A–C). After this, the donor heart was implanted in a standard fashion.3

FIGURE 1

FIGURE 1

In conventional cuff technique, a small clamp is used which clamps off both vessels and cuffs without any stabilization.3 During our early experience, we experienced unexpected movements of the cuffs secured by this small clamp when trying to evert vessels onto the cuffs. Because of unexpected movements, we occasionally failed to cuff the vessels. The custom-made clamp integrates a needle holder which makes the cuffs more secure maintaining a fixed position. This stabilization results in nearly no motion when everting vessels. Since the introduction of this clamp, we have not experienced any unexpected movements out of more than 150 HCHTs. This demonstrates reproducibility and benefit to those who use the cuff technique in HCHT. This should lead to a higher success rate.

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REFERENCES

1. Benke K, Sayour AA, Matyas C, et al. Heterotopic abdominal rat heart transplantation as a model to investigate volume dependency of myocardial remodeling. Transplantation. 2017;101:498–505.
2. Fukunaga N, Bissoondath V, Rao V. Submandibular gland-preserving technique for heterotopic cervical heart transplantation in mice. Transplantation. 2018;102:e464–e465.
3. Ratschiller T, Deutsch MA, Calzada-Wack J, et al. Heterotopic cervical heart transplantation in mice. J Vis Exp. 2015;102:e52907.
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