Percutaneous reimplantation of a pulmonary valved stent in sheep: a potential treatment for bioprosthetic valve degeneration.
OBJECTIVE
Percutaneous pulmonary valve replacement has been recently introduced into clinical practice. Patients with transcatheter pulmonary valve replacement will definitely face the problems of valve degeneration. In addition to surgical re-replacement of the degenerated bioprosthetic valves, we studied the replacement of degenerated bioprosthetic valves with transcatheter reimplantation of stent-mounted pulmonary valves.


METHODS
Percutaneous pulmonary valve replacement was first performed in 6 sheep used a homemade valved stent. Two months after the initial procedure, the 6 sheep previously implanted with a valved stent underwent the same implantation procedure of a pulmonary valved stent. Hemodynamic assessment of the bioprosthetic pulmonary valve was obtained by echocardiography immediately post-implant and at 2 months follow-up.


RESULTS
All 6 sheep had successful transcatheter stent-mounted pulmonary valve replacement in the first experiment. After 2 months, reimplantation was successful in 5 sheep but failed in 1 sheep because the first valved stent was pushed to the bifurcation of the pulmonary artery by the delivery sheath. Echocardiography confirmed the stents were in the desired position during the follow-up. The remaining 5 sheep with normal valvular and cardiac functionality survived for 3 months after implantation.


CONCLUSIONS
Transcatheter stent-mounted bioprosthetic pulmonary valve reimplantation is feasible in an animal model and more convenient than open chest reimplantation.
Bai
Yuan
Y
Department of Cardiology, Changhai Hospital, the Second Military Medical University, Shanghai, China.
Zong
Gang-Jun
GJ
Jiang
Hai-Bing
HB
Li
Wei-Ping
WP
Wu
Hong
H
Zhao
Xian-Xian
XX
Qin
Yong-Wen
YW
D000818:Animals; D001705:Bioprosthesis; D004452:Echocardiography; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D005260:Female; D006350:Heart Valve Prosthesis; D008297:Male; D023421:Models, Animal; D011475:Prosthesis Failure; D011664:Pulmonary Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D012756:Sheep; D015607:Stents