经导管主动脉瓣置换器械研制及动物实验方法  

Instruments development and experiment study for transcatheter aortic valve replacemet

作　　者：陈翔[1] 马丽萍[1] 张志钢[1] 白元[1] 王倩[1] 薛旺[1] 姜海滨[1] 李铭辉[1] 谭洪文 黄新苗[1] 赵仙先[1] 秦永文[1] 

机构地区：[1]第二军医大学附属长海医院心内科,上海200433

出　　处：《中国介入心脏病学杂志》2012年第4期221-224,共4页Chinese Journal of Interventional Cardiology

基　　金：国家高科技研究发展计划("863"计划;2006AAOZZ41D7)

摘　　要：目的探讨经导管置入新型带瓣膜球囊扩张支架,置换动物主动脉瓣的可行性和有效性。方法自行设计圆柱状网状支架,使用医用316L不锈钢激光雕刻而成。将新鲜的猪心包经脱细胞等处理后裁剪成人工瓣膜,缝合在不锈钢支架上,制成带瓣膜主动脉支架。手术前将带瓣膜支架压缩至定制的相应大小球囊的预载输送鞘管上。选择健康羊3只,开腹分离腹主动脉,穿刺腹主动脉,建立轨道,X线引导下沿加硬导丝经22F输送鞘管将带瓣膜支架逆行送至主动脉瓣位置,扩张球囊释放支架,置换原主动脉瓣。于手术后即刻观察实验效果。结果 1只实验羊因支架置入位置过低突入左心室造成动物心室颤动后死亡,另2只实验羊经导管瓣膜置换术均获得成功,术后即时影像及解剖结果表明人工主动脉瓣膜置入位置理想,可代替原瓣膜工作。结论经导管置入自制新型带瓣膜球囊扩张支架置换动物主动脉瓣方法可行,效果理想。Objective To evaluate the the feasibility, safety and function of transcatheter implantation a new-type stainless steel balloon-expandable valved stent into the aortic valve position of sheep. Methods A newly designed tube-like balloon-expandable valved stent made from 316 L stainless steel. Porcine pericardium was sutured by hand into the stainless steel stent. The valved stent was compressed on a balloon catheter and pulled into a 22-French sheath. Eighteen sheeps were included, we intended to implant valved stent through the infrarenal aorta. Hemodynamic evalution and imaging examination was carried out during the periodical follow up after implantation. Results Two devices were successfully delivered but one sheep died of stent misposition. No complications were noted during the procedure or the follow-up. Angiographic showed that the valved stents were in the desired position after implantation. No moderate to severe aortic regurgitation or stenosis was observed. Conclusions The aortic valved stent was implanted into the aortic position of sheep successfully, which has good structural stability. The study shows that the new- type valved stent and delivery system were safe and feasible.

关 键 词：心脏瓣膜假体植入 气囊扩张术 动物 实验 

分 类 号：R654.2[医药卫生—外科学]