824-5 Percutaneous aortic valve replacement with a self-expandable stent-valve in the beating heart: In vivo stress testing in an animal model

Ferrari, Markus; Hellige, G.; Schlosser, Markus; Werner, Gerald S.; Frerichs, Ines; Damm, C; Guyenot, Volker; Figulla, Hans R

doi:10.1016/s0735-1097(04)91833-5

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Porcine models of aortic PVL are commonly created by the implantation of a prosthetic valve (TAVI) (4). Prosthetic aortic valves can thereby be implanted either in an antegrade matter trans-apically through a subxiphoid access or minithoracotomy in the 6th intercostal space (69) or retrograde through a percutaneous access sheath in the femoral artery (70). Percutaneous approaches are often hampered by the need for large access sheaths increasing the risk for arterial dissection and perforation (71).…”

Section: Discussionmentioning

confidence: 99%

Dos and don'ts in large animal models of aortic insufficiency

et al. 2022

View full text Add to dashboard Cite

Aortic insufficiency caused by paravalvular leakage (PVL) is one of the most feared complications following transcatheter aortic valve replacement (TAVI) in patients. Domestic pigs (Sus scrofa domestica) are a popular large animal model to study such conditions and develop novel diagnostic and therapeutic techniques. However, the models based on prosthetic valve implantation are time intensive, costly, and often hamper further hemodynamic measurements such as PV loop and 4D MRI flow by causing implantation-related wall motion abnormalities and degradation of MR image quality. This study describes in detail, the establishment of a minimally invasive porcine model suitable to study the effects of mild-to-moderate “paravalvular“ aortic regurgitation on left ventricular (LV) performance and blood flow patterns, particularly under the influence of altered afterload, preload, inotropic state, and heart rate. Six domestic pigs (Swiss large white, female, 60–70 kg of body weight) were used to establish this model. The defects on the hinge point of aortic leaflets and annulus were created percutaneously by the pierce-and-dilate technique either in the right coronary cusp (RCC) or in the non-coronary cusp (NCC). The hemodynamic changes as well as LV performance were recorded by PV loop measurements, while blood flow patterns were assessed by 4D MRI. LV performance was additionally challenged by pharmaceutically altering cardiac inotropy, chronotropy, and afterload. The presented work aims to elaborate the dos and don'ts in porcine models of aortic insufficiency and intends to steepen the learning curve for researchers planning to use this or similar models by giving valuable insights ranging from animal selection to vascular access choices, placement of PV Loop catheter, improvement of PV loop data acquisition and post-processing and finally the induction of paravalvular regurgitation of the aortic valve by a standardized and reproducible balloon induced defect in a precisely targeted region of the aortic valve.

show abstract

Section: Discussionmentioning

confidence: 99%