{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T16:11:55Z","timestamp":1765901515105,"version":"3.48.0"},"reference-count":28,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pericardcheck GmbH","award":["37590-Medimplant1"],"award-info":[{"award-number":["37590-Medimplant1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Animal models are essential for translating diagnostic and therapeutic strategies into clinical practice and offer valuable insights into the pathophysiology of diseases such as aortic dissection. This study presents a novel acute in vivo large animal model of Stanford type A aortic dissection, combining open surgical access with endovascular techniques to leverage the advantages of both. The model aims to reproducibly simulate acute dissections in swine, providing a standardized platform for evaluating diagnostics, disease mechanisms, and treatment strategies. Methods: Six pigs underwent a standardized protocol to induce aortic dissection. Arterial pressure was monitored via femoral and carotid catheterization. A conventional sternotomy was performed, followed by tangential cross-clamping of the ascending aorta and a controlled incision proximal to the brachiocephalic trunk. The intima and the media were separated using a guidewire and catheter-based technique to create a false lumen. A re-entry tear was also established to allow for controlled intraluminal access. Animals were monitored for 12 h post-intervention, with serial blood sampling. At the end of the experiment, the animals were euthanized and the aortas harvested for macroscopic and histological analysis. Results: In all 6 animals, the placement of arterial catheters in femoral and carotid arteries, as well as the sternotomy, was established without any complications. The dissection model was successfully created in 5 out of 6 animals by clinical signs such as adventitial hematoma, macroscopic wall separation and\/or decreased femoral blood pressure. One animal experienced complete aortic perforation. Five animals completed the full observation period of 12 h. Conclusion: A standardized, reproducible, and robust large animal model of acute Stanford type A aortic dissection using a hybrid approach was developed. This model closely simulates the clinical and pathological features of human aortic dissection, making it a valuable tool for preclinical research in diagnostics, pathophysiology, and treatment development.<\/jats:p>","DOI":"10.3390\/jcdd12120496","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T15:41:12Z","timestamp":1765899672000},"page":"496","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of an Acute Large Animal Model for Type A Aortic Dissection"],"prefix":"10.3390","volume":"12","author":[{"given":"Ezin","family":"Deniz","sequence":"first","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sibylle","family":"Marsen","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5788-974X","authenticated-orcid":false,"given":"Florian","family":"Helms","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heike","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2207-7730","authenticated-orcid":false,"given":"Naoki","family":"Arima","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmin","family":"Hanke","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7774-5065","authenticated-orcid":false,"given":"Ali Saad","family":"Merzah","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadeq","family":"Al-Hasan-Al-Saegh","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7571-3775","authenticated-orcid":false,"given":"Sara","family":"Knigge","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saman","family":"Alhowaizy","sequence":"additional","affiliation":[{"name":"Pericardcheck GmbH, 28211 Bremen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanja","family":"Meyer","sequence":"additional","affiliation":[{"name":"Medimplant GmbH, 30173 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabea","family":"Hinkel","sequence":"additional","affiliation":[{"name":"Institute for Animal Hygiene, Animal Welfare and Farm Animal Ethology (ITTN), University of Veterinary Medicine Hannover, 30559 Hannover, Germany"},{"name":"Laboratory Animal Science Unit, German Primate Center (DPZ), Leibniz Institute of Primate Research, 37077 G\u00f6ttingen, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Lower Saxony, 37077 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4553-6608","authenticated-orcid":false,"given":"Morsi","family":"Arar","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4226-3004","authenticated-orcid":false,"given":"Aron F.","family":"Popov","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Asklepios Klinikum Harburg, 21075 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00fcnes","family":"Dogan","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastian","family":"Schmack","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Weymann","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2725-9912","authenticated-orcid":false,"given":"Arjang","family":"Ruhparwar","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salaheldien Ali","family":"Mohamed-Gl\u00fcer","sequence":"additional","affiliation":[{"name":"Pericardcheck GmbH, 28211 Bremen, Germany"},{"name":"University Hospital Schleswig-Holstein, UKSH Campus Luebeck, 23538 Luebeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan D.","family":"Schmitto","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1001\/jama.283.7.897","article-title":"The International Registry of Acute Aortic Dissection (IRAD): New insights into an old disease","volume":"283","author":"Hagan","year":"2000","journal-title":"JAMA"},{"key":"ref_2","unstructured":"Franco, K.L., and Verrier, E.D. 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