TRANSLUMINAL IMPLANTATION OF ARTIFICIAL-HEART VALVES - DESCRIPTION OF A NEW EXPANDABLE AORTIC-VALVE AND INITIAL RESULTS WITH IMPLANTATION BY CATHETER TECHNIQUE IN CLOSED CHEST PIGS
TRANSLUMINAL IMPLANTATION OF ARTIFICIAL-HEART VALVES - DESCRIPTION OF A NEW EXPANDABLE AORTIC-VALVE AND INITIAL RESULTS WITH IMPLANTATION BY CATHETER TECHNIQUE IN CLOSED CHEST PIGS
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DOI：
10.1093/oxfordjournals.eurheartj.a060238
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发表时间：
1992-05-01
影响因子：
39.3
通讯作者：
HASENKAM, JM
中科院分区：
文献类型：
--
作者：
ANDERSEN, HR;KNUDSEN, LL;HASENKAM, JM
本文介绍了一种新的人工主动脉瓣植入术，该术式无需开胸手术或体外循环。通过将猪主动脉瓣安装到可扩张支架中来制备新的心脏瓣膜。植入前，将支架瓣膜安装在球囊导管上，并在回缩球囊周围压缩。然后将支架瓣膜安装球囊导管逆行推进至麻醉猪的升主动脉或主动脉根部。通过球囊扩张进行植入，将支架-瓣膜扩张至超过血管内径的直径，从而确保与血管壁的稳定固定。在7头70 kg闭胸猪中共进行了9次麻醉。分别在2头和3头猪中进行冠状动脉下和冠状动脉上植入，同时在2头猪中进行两种位置的植入。植入后的血管造影和血流动力学评价显示，9个瓣膜中的任何一个均无明显狭窄（< 16 mmHg），仅2个瓣膜轻微返流。在三只动物中，并发症与冠状动脉血流受限有关。初步研究表明，经腔导管技术可以在闭胸动物体内植入人工主动脉瓣。
A new artificial aortic valve prosthesis was developed for implantation by the transluminal catheter technique without thoracotomy or extracorporal circulation. The new heart valve was prepared by mounting a porcine aortic valve into an expandable stent. Before implantation, the stent-valve was mounted on a balloon catheter and compressed around the deflated balloon. The stent-valve mounted balloon catheter was then advanced retrogradely to the ascending aorta or the aortic root in anaesthetized pigs. Implantation was performed by balloon inflation which expanded the stent-valve to a diameter exceeding the internal diameter of the vesselemdash thus ensuring a stable fixation against the vessel wall. A total of nine implantations were performed in seven 70 kg closed chest pigs. Sub- and supracoronary implantation was performed in two and three pigs, respectively, while implantation in both positions was done in two. Angiographic and haemodynamic evaluation after implantation revealed no significant stenosis (< 16 mmHg) in any of the nine valves and trivial regurgi-tation in only two. Complications were associated with restriction of the coronary blood flow in three animals. This preliminary study indicates that artificial aortic valves can be implanted in closed chest animals by transluminal catheter technique.