Percutaneous pulmonary polyurethane valved stent implantation

Metzner, Anja; Iino, Kenji; Steinseifer, Ulrich; Uebing, Anselm; Buhr, Wiebke de; Cremer, Jochen; Lutter, Georg

doi:10.1016/j.jtcvs.2009.08.013

Cited by 14 publications

(7 citation statements)

References 14 publications

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“…Moreover, Metzner et al [9] have demonstrated an excellent valve function of polyurethane valves with a self-expanding stent in the pulmonary position of 7 sheep in a period of 4 weeks. Gross morphology demonstrated good opening and closure characteristics and the valve leaflets were thin and pliable without indurations or calcification.…”

Section: Discussionmentioning

confidence: 99%

“…The angles from inferior vena cava to right ventricle and from right ventricle to pulmonary artery in sheep are more sharp than those in human. So, it is difficult to deliver the sheath from femoral vein to pulmonary valve in sheep model [28], and it is easy to induce arrhythmia during this procedure [9]. In Metzner’s study [9], rhythm disturbances occurred in all animals.…”

Section: Discussionmentioning

confidence: 99%

“…So, it is difficult to deliver the sheath from femoral vein to pulmonary valve in sheep model [28], and it is easy to induce arrhythmia during this procedure [9]. In Metzner’s study [9], rhythm disturbances occurred in all animals. Likewise, in our preliminary test, we had tried transfemoral approach in sheep with a 14F sheath, but we failed to deliver the sheath to pulmonary valve because of the sharp turning from tricuspid valve to pulmonary valve in sheep, and the repeated procedure led to ventricular fibrillation and death.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Metzner et al [9] have demonstrated an excellent outcome of polyurethane valves with a self-expanding stent in the pulmonary position of sheep in a period of 4 weeks.…”

Section: Introductionmentioning

confidence: 99%

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Transcatheter Pulmonary Valve Replacement by Hybrid Approach Using a Novel Polymeric Prosthetic Heart Valve: Proof of Concept in Sheep

Zhang

Chen

et al. 2014

PLoS ONE

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BackgroundSince 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.MethodsWe 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.FindingsImplantation 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.ConclusionsThis 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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Recently, Metzner et al [9] have demonstrated an excellent outcome of polyurethane valves with a self-expanding stent in the pulmonary position of sheep in a period of 4 weeks.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transcatheter Pulmonary Valve Replacement by Hybrid Approach Using a Novel Polymeric Prosthetic Heart Valve: Proof of Concept in Sheep

Zhang

Chen

et al. 2014

PLoS ONE

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“…Further experimental studies will help define the durability and safety of this new atrioventricular valved stent in animal models with different pathologies. In this study, pericardial heart valves were used; other types of foldable valves such as tricuspid polyurethane heart valves [12] or tissue-engineered heart valves [13] may also prove suitable.…”

Section: Future Prospectsmentioning

confidence: 99%

Mitral valved stent implantation☆☆☆

Lutter¹,

Quaden²,

Iino³

et al. 2010

European Journal of Cardio-Thoracic Surgery

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Transcatheter Heart Valves: A Biomaterials Perspective

Bui

Khair

Yeats

et al. 2021

Adv Healthcare Materials

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Heart valve disease is prevalent throughout the world, and the number of heart valve replacements is expected to increase rapidly in the coming years. Transcatheter heart valve replacement (THVR) provides a safe and minimally invasive means for heart valve replacement in high‐risk patients. The latest clinical data demonstrates that THVR is a practical solution for low‐risk patients. Despite these promising results, there is no long‐term (>20 years) durability data on transcatheter heart valves (THVs), raising concerns about material degeneration and long‐term performance. This review presents a detailed account of the materials development for THVRs. It provides a brief overview of THVR, the native valve properties, the criteria for an ideal THV, and how these devices are tested. A comprehensive review of materials and their applications in THVR, including how these materials are fabricated, prepared, and assembled into THVs is presented, followed by a discussion of current and future THVR biomaterial trends. The field of THVR is proliferating, and this review serves as a guide for understanding the development of THVs from a materials science and engineering perspective.

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Percutaneous pulmonary polyurethane valved stent implantation

Abstract: In the present study we demonstrated successful merging of 2 novel technologies for percutaneous treatment of pulmonary valve diseases using polyurethane stent valve constructs.

Cited by 14 publications

References 14 publications

Transcatheter Pulmonary Valve Replacement by Hybrid Approach Using a Novel Polymeric Prosthetic Heart Valve: Proof of Concept in Sheep

Transcatheter Pulmonary Valve Replacement by Hybrid Approach Using a Novel Polymeric Prosthetic Heart Valve: Proof of Concept in Sheep

Mitral valved stent implantation☆☆☆

Transcatheter Heart Valves: A Biomaterials Perspective

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