A new self-expanding aortic stent valve with annular fixation: in vitro haemodynamic assessment.

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Serval ID
serval:BIB_D084D9885298
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A new self-expanding aortic stent valve with annular fixation: in vitro haemodynamic assessment.
Journal
European Journal of Cardio-thoracic Surgery
Author(s)
Vergnat M., Henaine R., Kalejs M., Bommeli S., Ferrari E., Obadia J.F., Von Segesser L.K.
ISSN
1873-734X[electronic]
Publication state
Published
Issued date
2009
Volume
35
Number
6
Pages
970-975; discussion 975-6
Language
english
Abstract
OBJECTIVE: Balloon-expandable stent valves require flow reduction during implantation (rapid pacing). The present study was designed to compare a self-expanding stent valve with annular fixation versus a balloon-expandable stent valve. METHODS: Implantation of a new self-expanding stent valve with annular fixation (Symetis, Lausanne, Switzerland) was assessed versus balloon-expandable stent valve, in a modified Dynatek Dalta pulse duplicator (sealed port access to the ventricle for transapical route simulation), interfaced with a computer for digital readout, carrying a 25 mm porcine aortic valve. The cardiovascular simulator was programmed to mimic an elderly woman with aortic stenosis: 120/85 mmHg aortic pressure, 60 strokes/min (66.5 ml), 35% systole (2.8 l/min). RESULTS: A total of 450 cardiac cycles was analysed. Stepwise expansion of the self-expanding stent valve with annular fixation (balloon-expandable stent valve) resulted in systolic ventricular increase from 120 to 121 mmHg (126 to 830+/-76 mmHg)*, and left ventricular outflow obstruction with mean transvalvular gradient of 11+/-1.5 mmHg (366+/-202 mmHg)*, systolic aortic pressure dropped distal to the valve from 121 to 64.5+/-2 mmHg (123 to 55+/-30 mmHg) N.S., and output collapsed to 1.9+/-0.06 l/min (0.71+/-0.37 l/min* (before complete obstruction)). No valve migration occurred in either group. (*=p<0.05). CONCLUSIONS: Implantation of this new self-expanding stent valve with annular fixation has little impact on haemodynamics and has the potential for working heart implantation in vivo. Flow reduction (rapid pacing) is not necessary.
Keywords
Aortic Valve/surgery, Blood Pressure/physiology, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Hemodynamics/physiology, Humans, Models, Cardiovascular, Prosthesis Design, Stents, Surgical Procedures, Minimally Invasive/methods, Ventricular Pressure/physiology
Pubmed
Web of science
Open Access
Yes
Create date
02/09/2009 14:38
Last modification date
25/09/2019 7:10
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