title: Postmortem circulation: a new model for testing endovascular devices and training clinicians in their use.
abstract: The development of new medical devices, such as aortic valves, requires numerous preliminary studies on animals and training of personnel on cadavers before the devices can be used in patients. Postmortem circulation, a technique used for postmortem angiography, allows the vascular system to be reperfused in a way similar to that in living persons. This technique is used for postmortem investigations to visualize the human vascular system and to make vascular diagnoses. Specific material for reperfusing a human body was developed recently. Our aim was to investigate whether postmortem circulation that imitates in vivo conditions allows for the testing of medical materials on cadavers. We did this by delivering an aortic valve using minimally invasive methods. Postmortem circulation was established in eight corpses to recreate an environment as close as possible to in vivo conditions. Mobile fluoroscopy and a percutaneous catheterization technique were used to deliver the material to the correct place. Once the valve was implanted, the heart and primary vessels were extracted to confirm its position. Postmortem circulation proved to be essential in several of the cadavers because it helped the clinicians to deliver the material and improve their implantation techniques. Due to the intravascular circulation, sites with substantial arteriosclerotic stenosis could be bypassed, which would have been impossible without perfusion. Although originally developed for postmortem investigations, this reperfusion technique could be useful for testing new medical devices intended for living patients.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland; University Center of Legal Medicine Lausanne-Geneva, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Chevallier
authors.forename: Wouter
authors.initials: W
authors.lastname: Willaert
authors.forename: Emilia
authors.initials: E
authors.lastname: Kawa
authors.forename: Marcos
authors.initials: M
authors.lastname: Centola
authors.forename: Beat
authors.initials: B
authors.lastname: Steger
authors.forename: Richard
authors.initials: R
authors.lastname: Dirnhofer
authors.forename: Patrice
authors.initials: P
authors.lastname: Mangin
authors.forename: Silke
authors.initials: S
authors.lastname: Grabherr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001021:Aortic Valve; D002102:Cadaver; D057510:Endovascular Procedures; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D015424:Reperfusion / Q000379:methods*; D014057:Tomography, X-Ray Computed
keywords: aortic valve; clinical anatomy; postmortem perfusion; surgical training