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Related Experiment Videos

Percutaneous aortic valve replacement: resection before implantation.

René Quaden1, Tim Attmann, Andreas Boening

  • 1Department of Cardiovascular Surgery, School of Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Strasse 7, D-24105 Kiel, Germany.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|April 26, 2005
PubMed
Summary

High-pressure water jets can resect calcified aortic valves endoscopically. This novel technique shows promise for percutaneous valve replacement, but requires further development for clinical application.

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Area of Science:

  • Cardiovascular Surgery
  • Medical Device Technology
  • Interventional Cardiology

Background:

  • Calcified aortic valves pose a significant challenge in cardiovascular medicine.
  • Current treatment options for severe aortic stenosis often involve surgical or transcatheter valve replacement.
  • Novel minimally invasive techniques are needed to address calcified aortic valves.

Purpose of the Study:

  • To evaluate the feasibility of using a high-pressure water stream for endovascular resection of human calcified aortic valves.
  • To assess the safety and efficacy of this novel resection method in vitro and in a porcine model.

Main Methods:

  • Human calcified aortic valves were resected in vitro to optimize water jet parameters.
  • Porcine aortic valves were ablated in vitro to assess potential damage to surrounding structures.

Related Experiment Videos

  • Endoluminal resection was performed in a porcine model using microsystemic tools introduced via the descending aorta.

    • Main Results:

    • Resection of human calcified valves averaged 6.0 minutes per three leaflets at 150 bar.
    • In porcine models, endoluminal resection took 12.2 minutes per three leaflets at 60 bar.
    • Minor damage to the aortic annulus and wall was observed in some cases, with no significant impact on the mitral valve or left ventricular outflow tract.

    Conclusions:

    • Endoscopic percutaneous resection of calcified aortic valves using a high-pressure water stream is a feasible and promising auxiliary method.
    • Further development, including a debris-capturing device, is necessary before clinical application for percutaneous valve replacement.