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Transcatheter pulmonary valve replacement by hybrid approach using a novel polymeric prosthetic heart valve: proof of concept in sheep

Zhang, Ben ; Chen, Xiang ; Xu, Tong-yi ; Zhang, Zhi-gang ; Li, Xin ; Han, Lin ; Xu, Zhi-yun Frati, Giacomo

PloS one, 2014-06, Vol.9 (6), p.e100065-e100065 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Transcatheter pulmonary valve replacement by hybrid approach using a novel polymeric prosthetic heart valve: proof of concept in sheep
Autor: Zhang, Ben ; Chen, Xiang ; Xu, Tong-yi ; Zhang, Zhi-gang ; Li, Xin ; Han, Lin ; Xu, Zhi-yun
Frati, Giacomo
Assuntos: Angiography ; Animals ; Balloon treatment ; Biology and Life Sciences ; Calcification ; Cardiology ; Catheters ; Coated Materials, Biocompatible - chemistry ; Coated Materials, Biocompatible - therapeutic use ; Computed tomography ; Crosslinked polymers ; Defects ; Deformation ; Deformation mechanisms ; Dislocation ; Dislocations ; Durability ; Echocardiography ; Feasibility Studies ; Glutaraldehyde ; Health care delivery ; Heart ; Heart diseases ; Heart surgery ; Heart Valve Prosthesis ; Heart valves ; Hospitals ; Implantation ; Implants ; Laboratory animals ; Male ; Medical instruments ; Medicine and Health Sciences ; Membranes ; Membranes, Artificial ; Models, Animal ; Ovis aries ; Pericardium ; Phosphorylcholine ; Phosphorylcholine - chemistry ; Phosphorylcholine - therapeutic use ; Polymer crosslinking ; Polymers - chemistry ; Polytetrafluoroethylene ; Polytetrafluoroethylene - chemistry ; Polytetrafluoroethylene - therapeutic use ; Prostheses ; Prosthesis Design ; Prosthetic valves ; Pulmonary Valve - surgery ; Sheep ; Stent (Surgery) ; Stents ; Surgical implants ; Thrombosis ; Transcatheter Aortic Valve Replacement - instrumentation ; Transcatheter Aortic Valve Replacement - methods ; Valve leaflets
É parte de: PloS one, 2014-06, Vol.9 (6), p.e100065-e100065
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
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Conceived and designed the experiments: LH ZX. Performed the experiments: BZ XC TX ZZ XL LH. Analyzed the data: BZ XC. Contributed reagents/materials/analysis tools: ZX. Wrote the paper: BZ XC.
Competing Interests: The authors have declared that no competing interests exist.
Descrição: Since 2000, transcatheter pulmonary valve replacement has steadily advanced. However, the available prosthetic valves are restricted to bioprosthesis which have defects like poor durability. Polymeric heart valve is thought as a promising alternative to bioprosthesis. In this study, we introduced a novel polymeric transcatheter pulmonary valve and evaluated its feasibility and safety in sheep by a hybrid approach. We designed a novel polymeric trileaflet transcatheter pulmonary valve with a balloon-expandable stent, and the valve leaflets were made of 0.1-mm expanded polytetrafluoroethylene (ePTFE) coated with phosphorylcholine. We chose glutaraldehyde-treated bovine pericardium valves as control. Pulmonary valve stents were implanted in situ by a hybrid transapical approach in 10 healthy sheep (8 for polymeric valve and 2 for bovine pericardium valve), weighing an average of 22.5±2.0 kg. Angiography and cardiac catheter examination were performed after implantation to assess immediate valvular functionality. After 4-week follow-up, angiography, echocardiography, computed tomography, and cardiac catheter examination were used to assess early valvular function. One randomly selected sheep with polymeric valve was euthanized and the explanted valved stent was analyzed macroscopically and microscopically. Implantation was successful in 9 sheep. Angiography at implantation showed all 9 prosthetic valves demonstrated orthotopic position and normal functionality. All 9 sheep survived at 4-week follow-up. Four-week follow-up revealed no evidence of valve stent dislocation or deformation and normal valvular and cardiac functionality. The cardiac catheter examination showed the peak-peak transvalvular pressure gradient of the polymeric valves was 11.9±5.0 mmHg, while that of two bovine pericardium valves were 11 and 17 mmHg. Gross morphology demonstrated good opening and closure characteristics. No thrombus or calcification was seen macroscopically. This design of the novel ePTFE transcatheter pulmonary valve is safe and effective to deploy in sheep by hybrid approach, and the early valvular functionality is good.
Editor: United States: Public Library of Science
Idioma: Inglês

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Transcatheter pulmonary valve replacement by hybrid approach using a novel polymeric prosthetic heart valve: proof of concept in sheep

Zhang, Ben ; Chen, Xiang ; Xu, Tong-yi ; Zhang, Zhi-gang ; Li, Xin ; Han, Lin ; Xu, Zhi-yun Frati, Giacomo

United States: Public Library of Science

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