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CURRENT ISSUEITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Scopus

Frequency: Quarterly

ISSN 1824-4777

Online ISSN 1827-1847

 

Italian Journal of Vascular and Endovascular Surgery 2012 December;19(4):229-36

    ORIGINAL ARTICLES

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.

language: English


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