New Self-Expanding Transcatheter Valve for Off-Pump Transatrial Mitral Valve-In-Ring Implantation
| Autor: | Linfeng Qian, Yu Zou, Liang Ma, Jianjie Jiang, Christoph Huber, Chengchen Li, Zipu Yu |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty Mitral Valve Annuloplasty Swine medicine.medical_treatment Operative Time Hemodynamics 610 Medicine & health Regurgitation (circulation) Prosthesis Design law.invention law Internal medicine Mitral valve Mitral valve annuloplasty Cardiopulmonary bypass Animals Medicine Pharmacology (medical) Thoracotomy Procedure time Cardiac catheterization Heart Valve Prosthesis Implantation Cardiopulmonary Bypass business.industry Prosthesis Failure Surgery medicine.anatomical_structure Echocardiography Cardiology Mitral Valve Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | Ma, Liang; Yu, Zipu; Huber, Christoph; Li, Chengchen; Qian, Linfeng; Jiang, Jianjie; Zou, Yu (2015). New Self-Expanding Transcatheter Valve for Off-Pump Transatrial Mitral Valve-In-Ring Implantation. Cardiology, 132(4), pp. 221-227. Karger 10.1159/000433595 |
| ISSN: | 1421-9751 0008-6312 |
| DOI: | 10.1159/000433595 |
| Popis: | Objectives: To validate a self-expanding transcatheter valve for off-pump transatrial mitral valve-in-ring (VIR) implantation via a left thoracotomy. Methods: Mitral valve annuloplasty was performed via sternotomy during cardiopulmonary bypass on 9 pigs. After successful weaning from extracorporal circulation, the custom-made, self-expanding transcatheter VIR device was deployed under fluoroscopic guidance within the annuloplasty ring via a left thoracotomy. Hemodynamic data before and after the implantation were recorded. Mitral annulus diameter and valve area were measured by echocardiography. Transvalvular and left-ventricular outflow-tract pressure gradient were measured invasively. Results: Eight successful implantations were performed. Implantation failed in 1 pig because of difficulty with technical delivery of the sheath. Mean transatrial procedure time was 12.6 ± 1.7 min. Hemodynamic status during transatrial implantation was stable, and differences were not statistically significant. Mean mitral annulus diameter and mean mitral orifice area were 2.32 ± 0.2 and 3.84 ± 0.55 cm2, respectively. Mild regurgitation was detected in 7 animals and moderate regurgitation in 1. Mean gradients were 6.1 ± 5.0 mm Hg across the device. Postmortem examination confirmed adequate positioning of devices within the annuloplasty ring. Conclusions: This custom-made transcatheter device allows for safe and reproducible off-pump transatrial mitral VIR implantations. Transatrial access is a promising route to facilitate VIR implantations. Our custom-made stent-valve may be suitable for VIR procedures. |
| Databáze: | OpenAIRE |
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