Transapical off-pump removal of the native aortic valve: A proof-of-concept animal study

Salizzoni, Stefano; Bajona, Pietro; Zehr, Kenton J.; Anderson, William D.; Vandenberghe, Stijn; Speziali, Giovanni

doi:10.1016/j.jtcvs.2009.03.057

Cited by 13 publications

(8 citation statements)

References 29 publications

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“…Also similar to our findings, there were no changes in cardiac output or peak systolic pressure with the use of the temporary valve. Similar findings were observed in another temporary valve design with the appearance of a 'parachute' [8,9]. The wire-mounted, monoleaflet temporary valve apparatus was tested in vitro in a mechanical cardiovascular simulator as well as in vivo in a pig model.…”

Section: Discussionsupporting

confidence: 58%

“…In a beating heart without the protection of cardiopulmonary bypass support, explantation of the native aortic valve would cause massive aortic regurgitation leading to unsustainable global ischaemia and heart failure. Hence, the advent of the temporary aortic valve support concept is relevant to the continued development of the percutaneous or minimally-invasive transcatheter replacement procedure [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Qualitative haemodynamic validation of a percutaneous temporary aortic valve: a proof of concept study

Ho¹

2011

Journal of Medical Engineering & Technology

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The concept of temporary aortic valves has been suggested in the clinical settings of acute aortic regurgitation and transcatheter aortic valve replacement procedure (TAVR). In TAVR, suggestions have been made to pre-treat or remove the diseased aortic valve prior to implantation of the replacement valve. A successful temporary aortic valve must demonstrate the ability to prevent life-threatening haemodynamics of massive aortic regurgitation. A novel temporary aortic valve (TAV) design, comprised of inflatable balloon elements as a check-valve, can readily be deployed and retrieved via a catheter-system. A simple flow model is set up to test the TAV's performance in severe aortic regurgitation. With induced aortic regurgitation, placement of the TAV is found to increase the distal aortic diastolic pressure, to reduce the widened pulse pressure, to protect proximal aorta-left ventricle from diastolic pressure elevation and to reduce the aortic regurgitant volume. In conclusion, continued development of the TAV system can lead to a successful temporary aortic valve to be used in various appropriate clinical settings.

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Qualitative haemodynamic validation of a percutaneous temporary aortic valve: a proof of concept study

Ho¹

2011

Journal of Medical Engineering & Technology

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“…In striving towards a transapical beating-heart approach, the NeoChord DS 1000 (NeoChord, Inc., Minneapolis, MN, USA) device has been developed to realize minimally invasive MV repair with implantation of neochordae, under transesophageal echocardiographic (TEE) guidance [7]. The transapical off-pump MV intervention with NeoChord implantation (TOP-MINI) has been evaluated in animal studies [8][9][10], followed by initial clinical investigations [11,12].…”

Section: Introductionmentioning

confidence: 99%

Acute safety and efficacy of the NeoChord procedure

Colli

Manzan

Ručinskas

et al. 2015

Interact CardioVasc Thorac Surg

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“…The concept of pretreating the native valve has been discussed and proposed including valve debulking, modification and removal (9,(13)(14)(15). Substantial acute aortic insufficiency can occur during aortic valve pretreatment, and the hemodynamic protection of the TAV can allow for the development of valve pretreatment from concept to reality.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous aortic valve replacement (part 3): Balloon counterpulsation of a novel temporary aortic valve

Ho¹

2011

Minimally Invasive Therapy & Allied Technologies

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A previously published two-part study described an engineering design of a percutaneous aortic valve (PAV) replacement system, which utilizes a novel temporary aortic valve (TAV) support to improve procedural outcomes and safety. Conceptually, this investigational approach can promote accurate PAV placement, procedural hemodynamic stability, smaller catheter delivery system, reduction in PAV regurgitation, reduction in conduction and vascular complications. The balloon TAV can potentially facilitate the PAV replacement procedure by serving as the patient's surrogate aortic valve while the native valve is pretreated and replaced. The original TAV is designed to function with an effective aortic stenosis and insufficiency in moderate ranges, which lessens from the patient's more critical valve condition, should be well tolerated when the native valve becomes nonfunctional during the replacement process. Further optimization of the TAV's hemodynamic profile could further improve the system's overall performance and enhance the realization of a truly minimally invasive, cath lab-based PAV replacement procedure comparable to that of percutaneous coronary intervention. This study explores design permutations from the original published TAV, including varying the number of balloons and adding balloon counterpulsations, to improve upon its hemodynamic profile to better serve as the patient's surrogate valve and the overall PAV replacement procedure.

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Transapical off-pump removal of the native aortic valve: A proof-of-concept animal study

Cited by 13 publications

References 29 publications

Qualitative haemodynamic validation of a percutaneous temporary aortic valve: a proof of concept study

Qualitative haemodynamic validation of a percutaneous temporary aortic valve: a proof of concept study

Acute safety and efficacy of the NeoChord procedure

Percutaneous aortic valve replacement (part 3): Balloon counterpulsation of a novel temporary aortic valve

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