Percutaneous aortic valve replacement: an experimental study. I. Studies on implantation

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Medical Devices

Background:

• Minimally invasive aortic valve implantation is a growing field.
• Traditional aortic valve replacement often requires thoracotomy.
• A transluminal catheter technique offers a less invasive alternative.

Purpose of the Study:

• To devise and evaluate a new surgical procedure for minimally invasive aortic valve implantation.
• To assess the feasibility of a transluminal technique for aortic valve delivery.
• To investigate the performance of a novel collapsible aortic valved stent.

Main Methods:

• A porcine aortic valve was mounted into a nitinol stent.
• Valved stents underwent in vitro testing for pressure gradient and regurgitation.
• Successful valved stents were implanted in vivo into the descending and ascending aorta of pigs via a catheter delivery system.
• Transvalvular gradients, valvular function, and regurgitation were assessed.

Main Results:

• 11 out of 14 implanted valved stents showed successful short-term function.
• Low transvalvular gradients were observed, comparable to in vitro results.
• Complete valvular opening and closure were demonstrated by echocardiography.
• Minimal regurgitation was detected by angiography and Doppler ultrasonography.

Conclusions:

• Aortic valved stents can be successfully implanted without thoracotomy using a transluminal catheter technique.
• This preliminary study demonstrates the potential of the novel technique.
• Long-term functionality of these transluminally implanted aortic valved stents requires further investigation.