Off-pump transapical mitral valve replacement☆

• DOI: 10.1016/j.ejcts.2009.02.037
• Publication Date: 2009-04-27T07:57:08Z
• Authors: Georg Lutter; René Quaden; Satoru Osaki; Jian Hu; Jochen Renner; Niloo M. Edwards; Jochen Cremer; Lucian Lozonschi
• Keywords: Mitral valve replacement; Median sternotomy; Valve replacement

Percutaneous valve replacement was recently introduced, and reports of early clinical experience have already been published. To date, this technique is limited to the pulmonary aortic valves in a strictly selected group patients. The aim study analyse self-expanding valved stent for minimally invasive mitral animals.A newly designed nitinol specially experimental acute study. It comprised left ventricular tubular with star shaped atrial anchoring springs carried trileaflet bovine pericardial valve. A polytetrafluoroethylene membrane sutured envelop outside stent. system same as our previously reported results similar Seven pigs underwent off-pump implantation. This performed through lower mini-sternotomy standard transapical approach under transoesophageal echocardiographic (TEE) guidance used.The fully retrievable precise deployment accurate adjustment its intra-annular position achievable eliminate paravalvular leakage. time ranged from 127 255s blood loss 70 220cc. One animal died intractable fibrillation. Mitral regurgitation all surviving animals minimal (trace 5/6 mild 1/6 during echo examination; on contrast ventriculogram no insufficiency observed except one documented regurgitation). These remained haemodynamically stable (6/6) without TEE or ventriculographic changes 1h.Implantation tricuspid feasible transcatheter approach. possible smaller delivery than reported. Additional studies are required demonstrate long-term feasibility, durability, heart function.