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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Italian Journal of Vascular and Endovascular Surgery 2012 December;19(4):229-36
Transcatheter aortic valve implantation using a valved stent in profiling of valsalva sinus for regurgitation: a preliminary feasibility study in pigs
Huang H. 1, Zhou Y. 2, Wang Y. 2, Mei Y. 2, Feng J. 2, Shao J. 2, Cai J. 2
1 Department of Thoracic-Cardiovascular Surgery, Nantong First People’s Hospital, The Second Affiliation Hospital of Nantong University, Nantong, China;
2 Department of Thoracic-Cardiovascular Surgery, Tongji Hospital, Tongji University school of Medicine Shanghai, China
AIM: The aim of this study was to manufacture a valved stent in profiling of valsalva sinus and investigate it’s feasibility of transcatheter implantation in valsalva sinus.
METHODS: A nitinol stent in profiling of valsalva sinus, containing bovine pericardium valves, was implanted in pigs’ valsalva sinus transcatheter. Before implantation, one of native aortic valves was torn by balloon. After procedure, the characteristics of valved stents in vivo were observed and aortic regurgitation (AR) was measured. Additionally, survived pigs were sacrificed for macroscopic analysis.
RESULTS: Due to learning curve, the procedure failed in 5 pigs but succeeded in 11 pigs. The new valved stent in vivo had low transvalvular gradient and basic laminar blood flow. In 11 successful cases, AR decreased from 7.07±1.59 mL/s to 4.02±1.05 mL/s. Moderate regurgitation (II°) was found in all 11 animals after implantation, autopsy demonstrated that 8 cases had optimal position with obvious development of coronary artery, and 3 had moderate to severe rotation with moderate to mild development. Good geometrical matching (I°) between the valved stent and valsalva sinus was reached in 6 of 11 cases. All the native aortic valves located under artificial valves. No valved stent was found shifting towards proximal and distal.
CONCLUSION: This valved stent in profiling of valsalva sinus can be implanted in pig’s valsalva sinus transcatheter in beating heart, which had desirable fixing power in vivo. Valved stent with optimal position can avoid obstruction of coronary orifice.