Related Experiment Video
Updated: Jul 14, 2026
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An Ex Vivo Porcine Model for Hydrodynamic Testing of Experimental Aortic Valve Procedures and Novel Medical Devices
Published on: August 25, 2023
Coronary flow obstruction in percutaneous aortic valve replacement. An in vitro study
Erwan M Flecher1, John W Curry, Thomas M Joudinaud
1The International Heart Institute of Montana Foundation at Saint Patrick Hospital and Health Sciences Center and The University of Montana, Missoula, Montana 59802, USA.
Summary
Percutaneous aortic valve replacement with intact native leaflets caused coronary ostial obstruction. Excising native leaflets before stent implantation prevented this complication, suggesting modified stent designs are needed.
Area of Science:
- Cardiovascular research
- Interventional cardiology
- Biomedical engineering
Background:
- Coronary flow obstruction is a significant complication during percutaneous aortic valve replacement.
- Understanding the impact of valved stent implantation on coronary artery flow is crucial.
Purpose of the Study:
- To investigate the effect of valved stent implantation on coronary artery flow in porcine hearts.
- To compare outcomes with native valve leaflets intact versus excised.
Main Methods:
- Porcine hearts were used for an in vitro study.
- Coronary flow was measured before and after valved stent implantation.
- Two groups were studied: native leaflets intact (Group A) and native leaflets excised (Group B).
Main Results:
- Group A showed a significant decrease in both left and right coronary artery flow post-implantation.
- Group B demonstrated no significant change in coronary flow after valve placement.
- These findings indicate that the presence of native leaflets contributes to obstruction.
Conclusions:
- Implantation of percutaneous valved stents with intact native valves causes coronary ostial obstruction.
- Modified stent designs are necessary for patients with non-retracted, fibrotic, or calcified native aortic valve leaflets.
- This study underscores the importance of considering native valve anatomy during device selection and implantation.
