开胸经导管植入带瓣膜支架置换肺动脉瓣的实验观察

目的 探讨开胸经导管植入带瓣膜支架置换肺动脉瓣的可行性以及6个月的实验效果.方法 以新鲜的羊心包为材料,给予0.6％戊二醛浸泡36 h后缝合在瓣膜环上,并将其固定在镍钛记忆合金自膨胀支架上,制成带瓣膜肺动脉支架.选择体重为(23.5±3.1)kg的健康羊,通过开胸穿刺右心室前壁,将带瓣膜支架经导管植入至肺动脉瓣处,置换自身肺动脉瓣膜,随访6个月,观察实验效果.结果 1只羊术后4个月死于肺动脉支架内血栓形成,4只羊随访6个月,心脏彩色超声、右心室以及肺动脉瓣上造影证实支架的位置及瓣膜功能良好,64排CT检查发现支架无移位.结论 开胸经导管植入带瓣膜支架置换肺动脉瓣方法可行,随访6个月效果理想.

Transcatheter pulmonary valve replacement in sheeps:6-month evaluation of self-expanding valved stents

Objective The purpose of this study was to determine the feasibility of transcatheter pulmonary valve replacement in sheeps up to 6 months post procedure.Methods Fresh sheep pericardium treated with a 0.6％glutaraldehyde solution for 36 hours Was sutured to a valvular ring and then fixed onto a newly designed nitinol self-expandable stent.Thoracotomy Was performed in sheeps(23.5±3.1)kg under general anesthesia and the device was delivered into the native pulmonary valve of the sheeps via the anterior wall of right ventricle by catheter and fooled for 6 months.Results One sheep died 4 months after the procedure due to in-stent thrombosis.Another 4 animals survived the 6-month observing period.Angiographic and hemodynamic measurements confirmed good positioning and function of the stents with a competent valve immediately post procedure and 6 months post the procedure in surviving animals.Conclusion Implantation of the nitinol self-expandable stent in the pulmonary valve position by a transcatheter approach is feasible and good function of transcatheter implanted memory nitinol valved stents was shown after 6 months of implantation in sheeps.