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myocardium

Fig. 4. Placement of the occluder and releaser sutures. The placement of the occluder suture is shown in a dissected rat heart (A) and in a schematic illustration of the heart (B). The left atrium is used as a landmark, because the left main coronary artery runs along its medial side. The occluder suture is paced just at the lower edge of the atrium about 2-3 mm lateral on either side of its medial margin [large arrow in (B), marked by asterisks (**)], and at a depth of about 2 mm. Placement of the occluder suture around the left main coronary artery (LCA) is marked by a dashed line in (C). The drawing in (C) illustrates the knots tied in the occluder and releaser sutures during surgery. The occluder suture runs just under the LCA (marked by an arrow), as indicated by a dashed line. LA, Left atrium; LV, left ventricle; PA, pulmonary artery; RA, right atrium; RV, right ventricle; O, occluder suture; R, releaser suture.

Intravenous catheter (21 gauge; Terumo Medical, Tokyo, Japan) Animal respirator (CIV-101; Columbus Instruments, Columbus, OH) High-temperature cautery (model CRS-232; Roboz Surgical, Rockville, MD)

4-0 coated Vicryl braided suture with cutting PS-2 needle (Ethicon, Cincinnati, OH)

5-0 silk black braided suture with taper C-l needle (Ethicon) 2-0 and 7-0 black braided silk suture (Ethicon)

Fig. 3. Surgical preparation of the rat ischemia-reperfusion model. (A) Male Wistar rats are anesthetized to a surgical plane and intubated with a catheter tied tightly in place with a suture. The rat is maintained on artificial respiration for the duration of the surgery. (B and C) A left thoracotomy is performed and the chest cavity is opened and gently spread with three small retractors. Sterilized bent paper clips hooked to rubber bands and anchored to the surgery board with pins can serve as effective retractors. After the pericardium is pierced to expose the heart, adenoviral infection is accomplished via coronary infusion, as described in text. (C) The occluder and releaser sutures are then implanted around the left coronary artery and tested. The ends of these sutures are inserted through the body wall and skin before closing all incisions, but are then reinserted under the skin, leaving only a small loop exposed on the exterior. (D) An illustration of the freed ends of the occluder (O) and releaser (R) sutures, which are accessible for experimental induction of ischemia and reperfusion 3 days after the surgical preparation.

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