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Advances in experimental percutaneous pulmonary valve replacement
Tim Attmann1, Thomas Jahnke, René Quaden
1Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Kiel, Germany.
The Annals of Thoracic Surgery
|August 27, 2005
Summary
This study shows self-expanding nitinol valved stents can be effectively implanted in the pulmonary position via a transfemoral approach in sheep, offering a new option for percutaneous pulmonary valve replacement.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Interventional Cardiology
Background:
- Percutaneous pulmonary valve implantation is an emerging alternative to traditional surgery.
- Current methods use balloon-in-balloon techniques.
- Self-expanding stents may improve valve preservation and long-term function.
Purpose of the Study:
- To describe the initial experience with a percutaneous transfemoral pulmonary valve implantation technique.
- To evaluate the use of self-expanding valved stents for this procedure.
Main Methods:
- Bovine jugular xenografts were integrated into nitinol stents.
- In vitro functional tests were performed.
- Transfemoral implantation was acutely evaluated in 6 sheep, with radiologic (angiography, MSCT) and pathoanatomical assessments.
Main Results:
- Successful implantation in the pulmonary position was achieved in 5 of 6 sheep.
- One sheep experienced early stent migration, and another died due to delivery system perforation.
- MSCT confirmed orthotopic stent position in 4 sheep, with a mean transvalvular gradient of 8.2 +/- 3.9 mm Hg.
Conclusions:
- Memory nitinol valved stents can be optimally deployed in the pulmonary position via a transfemoral approach in a sheep model.
- This technique shows promise for percutaneous pulmonary valve replacement.