Minimally invasive insertion of an equine stented pulmonary valve with a built-in sinus portion in a sheep model

TY - JOUR

T1 - Minimally invasive insertion of an equine stented pulmonary valve with a built-in sinus portion in a sheep model

AU - Dodge-Khatami, Ali

AU - Hallhagen, Stefan

AU - Limacher, Kuno

AU - Söderberg, Björn

AU - Jenni, Rolf

N1 - Copyright © 2011 Wiley Periodicals, Inc.

PY - 2012/3/1

Y1 - 2012/3/1

N2 - OBJECTIVES: This study evaluated the feasibility of inserting a new equine stented-valve with a sinus portion in a lamb survival model, through a minimally invasive thoracotomy with right ventricular access without cardiopulmonary bypass.BACKGROUND: Extant surgical or percutaneous methods for inserting biological valves in the right outflow tract have drawbacks and limitations.METHODS: A decellularized equine valved jugular vein, sutured to a self-expanding stent with a sinus portion, was placed through a minimal right thoracotomy using a newly developed flexible hydraulic release device in seven lambs. The approach through the right ventricle into the pulmonary valve position is achieved on a beating heart.RESULTS: The stented valves were correctly positioned in the right outflow tract, were competent up to 6 months as confirmed by angiography and echocardiography, and were well-tolerated by the animals, with endothelialization of the valve demonstrated at 6 months.CONCLUSIONS: The newly developed hydraulic release system allowed for safe and reliable insertion of an equine stented-valve with a sinus portion, through a right transventricular approach on a beating heart, in a sheep survival model.

AB - OBJECTIVES: This study evaluated the feasibility of inserting a new equine stented-valve with a sinus portion in a lamb survival model, through a minimally invasive thoracotomy with right ventricular access without cardiopulmonary bypass.BACKGROUND: Extant surgical or percutaneous methods for inserting biological valves in the right outflow tract have drawbacks and limitations.METHODS: A decellularized equine valved jugular vein, sutured to a self-expanding stent with a sinus portion, was placed through a minimal right thoracotomy using a newly developed flexible hydraulic release device in seven lambs. The approach through the right ventricle into the pulmonary valve position is achieved on a beating heart.RESULTS: The stented valves were correctly positioned in the right outflow tract, were competent up to 6 months as confirmed by angiography and echocardiography, and were well-tolerated by the animals, with endothelialization of the valve demonstrated at 6 months.CONCLUSIONS: The newly developed hydraulic release system allowed for safe and reliable insertion of an equine stented-valve with a sinus portion, through a right transventricular approach on a beating heart, in a sheep survival model.

KW - Animals

KW - Animals, Newborn

KW - Bioprosthesis

KW - Feasibility Studies

KW - Heart Valve Prosthesis

KW - Heart Valve Prosthesis Implantation/instrumentation

KW - Horses

KW - Jugular Veins/transplantation

KW - Models, Animal

KW - Prosthesis Design

KW - Pulmonary Valve/diagnostic imaging

KW - Radiography, Interventional

KW - Sheep

KW - Stents

KW - Thoracotomy

KW - Time Factors

KW - Ultrasonography

U2 - 10.1002/ccd.23354

DO - 10.1002/ccd.23354

M3 - SCORING: Journal article

C2 - 22110004

VL - 79

SP - 654

EP - 658

JO - CATHETER CARDIO INTE

JF - CATHETER CARDIO INTE

SN - 1522-1946

IS - 4

ER -