Stent-based, off-pump creation of an apico-aortic conduit.
An apico-aortic conduit (AAC) is an alternative therapy in patients with aortic valve stenosis and severe concomitant disease. We investigated whether it is feasible to create an apico-aortic conduit off-pump with a newly developed, stent-based coring- and cannulation-device in the animal model. A new self-expandable, stent equipped and hooked prosthesis and a sheath enabling both airtight removal of tissue and introduction of the prosthesis were designed and experimentally investigated in six pigs. Hemodynamic- and echocardiographic investigations were performed without and with aortic stenosis. In three animals MRI was performed. There was no significant blood loss, no relevant contamination with air and no hemodynamic depression during the whole procedure. It was possible to yield the entire cardiac output through the conduit after creating a high grade aortic stenosis. Autopsy revealed an excellent anchorage of the prosthesis. Neither relevant intracavitary injury nor thrombotic formation was seen. This study proves the feasibility of a stent-based, off-pump creation of an AAC. The principle of this approach might be used for other purposes.
Clinic for Cardiothoracic Surgery, University Hospital RWTH Aachen, Pauwelsstr 30, D-52074 Aachen, Germany. jspillner@ukaachen.de
Jan
J
Spillner
Nima
N
Hatam
Andrea
A
Amerini
Florian
F
Otte
Torsten
T
Linde
Gabriele
G
Krombach
Rudiger
R
Autschbach
Angelo
A
Carpi
Guido
G
Dohmen
D000818:Animals; D001011:Aorta; D005260:Female; D006350:Heart Valve Prosthesis; D008279:Magnetic Resonance Imaging; D015607:Stents; D013552:Swine