A new self-expanding aortic stent valve with annular fixation: in vitro haemodynamic assessment

Mathieu Vergnat, Roland Henaine, Martins Kalejs, Sandra Bommeli, Enrico Ferrari, Jean Francois Obadia, Ludwig Karl Von Segesser

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Objective: Balloon-expandable stent valves require flow reduction during implantation (rapid pacing). The present study was designed to compare a self-expanding stent valve with annular fixation versus a balloon-expandable stent valve. Methods: Implantation of a new self-expanding stent valve with annular fixation (Symetis®, Lausanne, Switzerland) was assessed versus balloon-expandable stent valve, in a modified Dynatek Dalta® pulse duplicator (sealed port access to the ventricle for transapical route simulation), interfaced with a computer for digital readout, carrying a 25 mm porcine aortic valve. The cardiovascular simulator was programmed to mimic an elderly woman with aortic stenosis: 120/85 mmHg aortic pressure, 60 strokes/min (66.5 ml), 35% systole (2.8 l/min). Results: A total of 450 cardiac cycles was analysed. Stepwise expansion of the self-expanding stent valve with annular fixation (balloon-expandable stent valve) resulted in systolic ventricular increase from 120 to 121 mmHg (126 to 830 ± 76 mmHg)*, and left ventricular outflow obstruction with mean transvalvular gradient of 11 ± 1.5 mmHg (366 ± 202 mmHg)*, systolic aortic pressure dropped distal to the valve from 121 to 64.5 ± 2 mmHg (123 to 55 ± 30 mmHg) N.S., and output collapsed to 1.9 ± 0.06 l/min (0.71 ± 0.37 l/min* (before complete obstruction)). No valve migration occurred in either group. (* = p < 0.05). Conclusions: Implantation of this new self-expanding stent valve with annular fixation has little impact on haemodynamics and has the potential for working heart implantation in vivo. Flow reduction (rapid pacing) is not necessary.

Original languageEnglish
Pages (from-to)970-976
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume35
Issue number6
DOIs
Publication statusPublished - Jun 2009
Externally publishedYes

Keywords

  • Aortic valve replacement
  • Balloon-expandable valved stent
  • Percutaneous valve replacement
  • Self-expandable valved stent
  • Transcatheter valve replacement
  • Valved stent

Field of Science

  • 3.2 Clinical medicine

Publication Type

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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