Antegrade Transapical Branched Aortic Arch Endograft - a Feasibility Study in Pigs
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Antegrade Transapical Branched Aortic Arch Endograft - a Feasibility Study in Pigs. / Wipper, Sabine; Lohrenz, Christina; Ahlbrecht, Oliver; Akkra, Mohamad; Carpenter, Sebastian William; Tsilimparis, Nikolaos; Debus, Eike Sebastian; Detter, Christian; Larena-Avellaneda, Axel; Kölbel, Tilo.
in: J AM COLL CARDIOL, Jahrgang 62, Nr. 18, TCT-135, 2013, S. B43-B43.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › Konferenz-Abstract in Fachzeitschrift › Forschung › Begutachtung
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TY - JOUR
T1 - Antegrade Transapical Branched Aortic Arch Endograft - a Feasibility Study in Pigs
AU - Wipper, Sabine
AU - Lohrenz, Christina
AU - Ahlbrecht, Oliver
AU - Akkra, Mohamad
AU - Carpenter, Sebastian William
AU - Tsilimparis, Nikolaos
AU - Debus, Eike Sebastian
AU - Detter, Christian
AU - Larena-Avellaneda, Axel
AU - Kölbel, Tilo
PY - 2013
Y1 - 2013
N2 - Background: To describe the technique and proof the concept of a complete transapical deployment of a single sidebranch arch endograft in a porcine model.Methods: Eight domestic pigs were operated with antegrade transapical delivery of a single-sidebranch arch endograft including a mating stentgraft to the innominate artery. Technical feasibility, operating time, radiation parameters and hemodynamic changes were studied according to standardized protocol during baseline (T0), after establishing of the transapical access and through-and-through wire (T1) and after stent-graft deployment (T2). Myocardial and cerebral Perfusion were assessed by fluorescent-microspheres (FM) and transit-time-flow measurement (TTFM).Results: Transapical access, introduction and deployment of the endograft, sidebranch catheterization and deployment of the mating stent-graft were feasible in 6 of the 8 animals with unimpeded perfusion of the innominate artery. One animal was lost during transapical access, one during sire-branch catheterization. The mean operating and fluoroscopy times were 15747min and 15.93.2min. During introduction and deployment of the stent-graft transient aortic valve insufficiency occurred in all animals. Hemodynamic stability recovered within ten minutes after retrieval of the delivery system in all animals. The innominate artery was patent with unchanged TTFM-flow measurements throughout the procedure. FM evaluation revealed stable myocardial and cerebral perfusion.Conclusions: Antegrade transapical access to the aortic arch for implantation ofa single sidebranch arch endograft is feasible in a porcine model with reversibleimpact on hemodynamic measures during deployment. Transapical access allows for deployment of a complex endograft through a single large bore access-site in a porcine model. It might be a future treatment option for selective patients.
AB - Background: To describe the technique and proof the concept of a complete transapical deployment of a single sidebranch arch endograft in a porcine model.Methods: Eight domestic pigs were operated with antegrade transapical delivery of a single-sidebranch arch endograft including a mating stentgraft to the innominate artery. Technical feasibility, operating time, radiation parameters and hemodynamic changes were studied according to standardized protocol during baseline (T0), after establishing of the transapical access and through-and-through wire (T1) and after stent-graft deployment (T2). Myocardial and cerebral Perfusion were assessed by fluorescent-microspheres (FM) and transit-time-flow measurement (TTFM).Results: Transapical access, introduction and deployment of the endograft, sidebranch catheterization and deployment of the mating stent-graft were feasible in 6 of the 8 animals with unimpeded perfusion of the innominate artery. One animal was lost during transapical access, one during sire-branch catheterization. The mean operating and fluoroscopy times were 15747min and 15.93.2min. During introduction and deployment of the stent-graft transient aortic valve insufficiency occurred in all animals. Hemodynamic stability recovered within ten minutes after retrieval of the delivery system in all animals. The innominate artery was patent with unchanged TTFM-flow measurements throughout the procedure. FM evaluation revealed stable myocardial and cerebral perfusion.Conclusions: Antegrade transapical access to the aortic arch for implantation ofa single sidebranch arch endograft is feasible in a porcine model with reversibleimpact on hemodynamic measures during deployment. Transapical access allows for deployment of a complex endograft through a single large bore access-site in a porcine model. It might be a future treatment option for selective patients.
U2 - http://ac.els-cdn.com/S0735109713042666/1-s2.0-S0735109713042666-main.pdf?_tid=6056c674-7288-11e4-8352-00000aab0f01&acdnat=1416689258_c835e6416ba302dbea10c26997f4855d
DO - http://ac.els-cdn.com/S0735109713042666/1-s2.0-S0735109713042666-main.pdf?_tid=6056c674-7288-11e4-8352-00000aab0f01&acdnat=1416689258_c835e6416ba302dbea10c26997f4855d
M3 - Konferenz-Abstract in Fachzeitschrift
VL - 62
SP - B43-B43
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 18
M1 - TCT-135
ER -
