title: Percutaneous aortic valve replacement: endovascular sealing studies in situ.
abstract: OBJECTIVE
  : To improve the outcome of percutaneous valve replacement in aortic stenosis endovascular resection of calcified aortic valves will be necessary. In this study different sealing methods were evaluated. The focus of this research was feasibility and mechanical functionality in human anatomy.
  
  
  METHODS
  : The aortic valve isolation chamber (AVIC) is a catheter-based system to seal the aortic valve during resection, and was installed antegrade and retrograde. Firstly, AVIC was inserted antegrade via the cardiac apex in human postmortem models (n = 2), and secondly in porcine in vivo models under extra corporeal circulation (n = 5). Endoscopic inspection of the valve was recorded. AVIC was installed via a port system through the descending aorta. Micro- and macropathologies were performed.
  
  
  RESULTS
  : AVIC transapical deployment in the two human models took 3 and 4 minutes respectively and 2.2 ± 1.3 minutes in average in the porcine model. From the descending aorta, the deployment took 9.3 ± 5.5 minutes. Fluoroscopy and macroscopy demonstrated sealed chambers. Microscopic and histologic analysis demonstrated no profound damages of the surrounding tissue.
  
  
  CONCLUSIONS
  : This study demonstrates the feasibility of transapical and retrograde endovascular sealing of the aortic valve in vitro and in vivo in nonbeating hearts.
authors.affiliation: From the *Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; †Institute for Microtechnology IMT, University of Braunschweig, Braunschweig, Germany; ‡Institute of Anatomy, Christian-Albrechts-University of Kiel, Kiel, Germany; §Institute of Biomedical Optics, University of Luebeck, Luebeck, Germany; ¶Division of Cardiothoracic Surgery, University of Wisconsin School of Medicine, Madison, WI.
authors.forename: René
authors.initials: R
authors.lastname: Quaden
authors.forename: Tim
authors.initials: T
authors.lastname: Attmann
authors.forename: Günther-Rudolf
authors.initials: GR
authors.lastname: Klaws
authors.forename: Michael
authors.initials: M
authors.lastname: Schünke
authors.forename: Dirk
authors.initials: D
authors.lastname: Theisen-Kunde
authors.forename: Lucian
authors.initials: L
authors.lastname: Lozonschi
authors.forename: Jochen
authors.initials: J
authors.lastname: Cremer
authors.forename: Georg
authors.initials: G
authors.lastname: Lutter