Transcatheter Aortic Valve Implantation Assisted with Microcatheter： A New Method to Avoid Coronary Artery Obstruction  

作　　者：Xiang Chen Guo-Jun Chu Fei-Yu Wang Yu-Feng Zhu Ben Zhang Xian-Xian Zhao Yong-Wen Qin Jun-Bo Ge 

机构地区：[1]Department of Cardiology, Zhongshan Hospital, Fudan UniversLty, Shanghai 200032, China [2]Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai 200043, China [3]Department of Cardiothoracic Surgery.Guangzhou General Hospitar of Guangzhou Mifltary Areal Guangzhou, Guangdong 510010, China3Department of Cardiothoracic Surgery.Guangzhou General Hospital of Guangzhou Military Area, Guangzhou, Guangdong 510010, China Xiang Chen and Guo-Jun Chu contributed equally to this study

出　　处：《Chinese Medical Journal》2015年第6期740-744,共5页中华医学杂志（英文版）

基　　金：This research was supported by China Postdoctoral Science Foundation

摘　　要：Background:Lack of fluoroscopic landmarks can make valve deployment more difficult in patients with absent aortic valve (AV)calcification.The goal of this article was to evaluate the feasibility and effectiveness oftranscatheter implantation of a valved stent into the AV position of a goat,assisted with a microcatheter which provides accurate positioning of coronary artery ostia to help valved stent deployment.Methods:The subjects were 10 healthy goats in this study.A microcatheter was introduced into the distal site of right coronary artery (RCA)through femoral artery sheath.A minimal thoracic surgery approach was used to access the apex of the heart.The apex of the left ventricle was punctured; a delivery catheter equipped with the valved stent was introduced over a stiffguidewire into the aorta arch.We could accurately locate the RCA ostia through the microcatheter placed in the RCA under fluoroscopy.After correct valve position was confirmed,the valved stent was implanted after rapid inflation of the balloon.The immediate outcome of the function of the valved stents was evaluated after implantation.Results:All ten devices were successfully implanted into the AV position of the goats.Immediate observation after the procedure showed that the valved stents were in the desired position after implantation by angiography,echocardiogram.No obstruction of coronary artery ostia occurred,and no moderate to severe aortic regurgitation was observed.Conclusions:When the procedure of transcatheter implantation of a balloon-expandable valved stent into the AV position of goats is assisted with microcatheter positioning coronary artery ostia,the success rate of operation can be increased in those with noncalcified AV.Background:Lack of fluoroscopic landmarks can make valve deployment more difficult in patients with absent aortic valve (AV)calcification.The goal of this article was to evaluate the feasibility and effectiveness oftranscatheter implantation of a valved stent into the AV position of a goat,assisted with a microcatheter which provides accurate positioning of coronary artery ostia to help valved stent deployment.Methods:The subjects were 10 healthy goats in this study.A microcatheter was introduced into the distal site of right coronary artery (RCA)through femoral artery sheath.A minimal thoracic surgery approach was used to access the apex of the heart.The apex of the left ventricle was punctured; a delivery catheter equipped with the valved stent was introduced over a stiffguidewire into the aorta arch.We could accurately locate the RCA ostia through the microcatheter placed in the RCA under fluoroscopy.After correct valve position was confirmed,the valved stent was implanted after rapid inflation of the balloon.The immediate outcome of the function of the valved stents was evaluated after implantation.Results:All ten devices were successfully implanted into the AV position of the goats.Immediate observation after the procedure showed that the valved stents were in the desired position after implantation by angiography,echocardiogram.No obstruction of coronary artery ostia occurred,and no moderate to severe aortic regurgitation was observed.Conclusions:When the procedure of transcatheter implantation of a balloon-expandable valved stent into the AV position of goats is assisted with microcatheter positioning coronary artery ostia,the success rate of operation can be increased in those with noncalcified AV.

关 键 词：AORTIC Valve Replacement STENT DISPOSITION STENT Migration PERCUTANEOUS 

分 类 号：R[医药卫生]