The newborn piglet: a large animal model of paediatric pulmonary hypertension

Pulmonary arterial hypertension (PAH) is a recognized complication of congenital heart disease with left-to-right shunting. Shunt-induced PAH is characterised by increased pulmonary vascular resistance and remodelling, eventually leading to right ventricular failure. Chronic systemic-to-pulmonary shunting in growing piglets has been shown to reproduce in a three-month period of time typical PAH features, that may require decades of life, to develop in patients born with cardiac malformations. The overcirculated piglet may represent the only realistic intact animal model of PAH.