Off-pump transapical mitral valve replacement : evaluation after one month
Off-pump transapical mitral valve replacement : evaluation after one month
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非体外循环经心尖二尖瓣置换术：一个月后评估
DOI：
10.1093/ejcts/ezr106
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Iino K
中科院分区：
文献类型：
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作者：
吉田麻子;和田大輝;菊池佳保理;一刈良介;木村朝子;柴田史久;田村秀行;Iino K
本研究调查结果一个月后植入猪与一种新的二尖瓣stent. METHODS新的镍钛合金支架定制设计的这项研究包括牛心包瓣膜。6只猪通过经心尖植入技术将瓣膜支架植入二尖瓣位置。之后，使用经食管超声心动图（TEE）、心室造影和心脏计算机断层扫描（CT），在植入后即刻（n= 6）、4周（n= 4）和8周（n= 1）评估血液动力学稳定性和瓣膜功能。植入后4周处死6只存活猪中的4只，8周处死1只。除1只动物外，所有动物均获得最佳展开和定位。该动物在4天后死于未识别的瓣膜支架定位不完善。新瓣膜和左心室流出道（LVOT）的平均跨瓣压差较小。6只动物中有1只在瓣膜支架展开后1小时出现轻度返流，此后无动物出现。所有动物在二尖瓣支架植入后表现出正常的血流动力学，并且在整个监测期间保持稳定。在4周和8周后，其余动物的移位、栓塞和瓣周漏不明显。总的评价显示，50-70%的心房元件被覆盖的组织生长在4周/8 weeks. CONCLUSIONSSThis研究表明充分部署和锚固的一个独特的，可重新定位的二尖瓣支架。观察4周的动物和8周后的一头猪显示出良好的瓣膜功能。
OBJECTIVESThe present study investigates outcomes one month after implanting pigs with a novel mitral valved stent.METHODSA novel nitinol stent custom designed for this study included a bovine pericardial valve. Six pigs received a valved stent into the mitral position by means of the transapical implantation technique. Afterwards, haemodynamic stability and valve function were assessed, immediately after implantation (n= 6), 4 weeks (n= 4) and 8 weeks (n= 1) thereafter using transoesophageal echocardiography (TEE), ventriculography and cardiac computed tomography (CT). Four of 6 surviving pigs were sacrificed at 4 weeks after implantation and one at 8 weeks thereafter.RESULTSOptimal deployment and positioning were obtained in all but one animal. This animal died of unrecognized imperfect valved stent positioning after 4 days. The average mean gradient across the new valves and the left ventricular outflow tract (LVOT) were small. Mild regurgitation developed after valved stent deployment in one of six animals just after 1 h, and in none thereafter. All animals exhibited normal haemodynamics after mitral valved stent implantation, and stability was maintained throughout the monitoring period. Migration, embolization and paravalvular leakage were not evident in the remaining animals after 4 and 8 weeks. Gross evaluation revealed that 50–70% of the atrial element was covered by tissue growth at 4 weeks/8 weeks.CONCLUSIONSThis study demonstrates adequate deployment and anchorage of a unique, repositionable mitral valved stent. A good valve function was revealed in animals observed for 4 weeks and in one pig after 8 weeks.