摘要
目的探讨开胸穿刺心尖经导管植入双环状主动脉瓣支架置换动物主动脉瓣的可行性和有效性。方法自主研制新型双环状主动脉瓣支架。选择健康实验山羊3头,侧开胸小切口显露心尖,穿刺左心室心尖建立轨道,透视下沿加硬导丝经22 F输送鞘管将双环状支架送至主动脉瓣上方,利用张开的支架外环准确定位于主动脉瓣窦底,随后扩张球囊释放支架,置换动物主动脉瓣。术后即刻观察评估实验效果。结果 3头实验羊经导管主动脉瓣植入(TAVI)术均获得成功,术后即刻DSA及解剖学评价表明人工主动脉瓣膜植入位置理想,代替原瓣膜工作。结论新型双环状主动脉瓣支架经心尖途径TAVI术可行,效果理想。
Objective To discuss the feasibility and effectiveness of transcatheter implantation of double-ring aortic valve stent through puncturing the tip of the heart under thoracotomy. Methods A novel double-ring aortic valve stent was independently designed by the authors. Three healthy goats were selected for this study. A small incision on the left anterolateral thoracic wall was made to expose the cardiac apex, than the puncturing of the left ventricular apex was performed to establish the working pathway. Guided by fluoroscopy, along a hard guide wire a double-ring aortic valve stent was inserted through a 22-French sheath to the site above the aortic valve. By utilizing the opened outer ring of the stent, the double-ring aortic valve stent was accurately placed at the bottom of the aortic valve sinus. Then, the balloon was inflated and the stent was released to substitute the original aortic valve of the experimental goat. The experiment results were evaluated immediately after the procedure. Results Transcatheter aortic valve implantation （TAVI） was successfully accomplished in all the three experimental goats. DSA was performed immediately after the procedure and anatomy evaluation indicated that the position of the implanted artificial aortic valve was satisfactory, which could replace the work of original valve. Conclusion It is technically feasible and clinically effective to use this novel double-ring aortic valve stent to perform TAVI through transapical route by puncturing the left ventricular apex.
出处
《介入放射学杂志》
CSCD
北大核心
2017年第4期344-349,共6页
Journal of Interventional Radiology
基金
国家自然科学基金青年项目(81500298)
关键词
经心尖路径
经导管主动脉瓣植入
主动脉瓣关闭不全
transapical route
transcatheter aortic valve implantation
aortic valve insufficiency
