Lucian Lozonschi1, Rene Quaden2, Jochen Cremer2, Niloo M. Edwards1, Georg Lutter2.
1Department of Cardiothoracic Surgery, University of Wisconsin School of Medicine, Madison, WI, USA, 2Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.
OBJECTIVE:
Transcatheter aortic and pulmonary valve replacement is currently being tested in clinical trials. Efforts to create a valved stent to replace the atrioventricular valves have shown minimal success. This is mostly due to their central location inside the heart and their complex anatomy and function.
METHODS:
A new valved stent was designed to overcome the difficulties associated with deployment and anchoring of a valved stent in the atrioventricular position.
RESULTS:
A valved stent carrying either a bovine jugular valve or porcine pulmonary valve was deployed successfully without cardiopulmonary bypass in a series of acute experiments in adult pigs. This was performed through a lower mini-sternotomy and a standard transapical approach under transesophageal echocardiographic (TEE) guidance. The valved stent is fully retrievable and precise deployment and accurate adjustment of its intra-annular position is achievable to eliminate paravalvular leak. The animals remained hemodynamically stable and without TEE or ventriculographic changes throughout the observation period (Table)
CONCLUSIONS:
Successful transapical mitral valve replacement with the new atrioventricular valved stent is feasible and highly reproducible in acute experimental setting. Chronic experiments are currently underway.
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