Cardioscopically-guided beating heart surgery: paravalvular leak repair - Ecole Nationale du Génie de l'Eau et de l'Environnement de Strasbourg
Article Dans Une Revue Annals of Thoracic Surgery Année : 2017

Cardioscopically-guided beating heart surgery: paravalvular leak repair

Zurab Machaidze
  • Fonction : Auteur
Margherita Mencattelli
  • Fonction : Auteur
Sunil Manjila
  • Fonction : Auteur
Borami Shin
  • Fonction : Auteur
Karl Price
  • Fonction : Auteur
Michael Borger
  • Fonction : Auteur
V. H. Thourani
  • Fonction : Auteur
Pedro del Nido
  • Fonction : Auteur
Christopher Baird
  • Fonction : Auteur
John Mayer
  • Fonction : Auteur
Pierre E. Dupont
  • Fonction : Auteur

Résumé

Purpose: There remains a paucity of direct visualization techniques for beating-heart intracardiac procedures. To address this need, we evaluated a novel cardioscope in the context of aortic paravalvular leaks (PVLs) localization and closure. Description: A porcine aortic PVL model was created using a custom-made bioprosthetic valve, and PVL presence was verified by epicardial echocardiography. Transapical delivery of occlusion devices guided solely by cardioscopy was attempted 13 times in a total of three pigs. Device retrieval after release was attempted six times. Echocardiography, morphologic evaluation, and delivery time were used to assess results. Evaluation: Cardioscopic imaging enabled localization of PVLs via visualization of regurgitant jet flow in a paravalvular channel at the base of the prosthetic aortic valve. Occluders were successfully placed in 11 of 13 attempts (84.6%), taking on average 3:03 ± 1:34 min. Devices were cardioscopically removed successfully in three of six attempts (50%), taking 3:41 ± 1:46 min. No damage to the ventricle or annulus was observed at necropsy. Conclusions: Cardioscopy can facilitate intracardiac interventions by providing direct visualization of anatomic structures inside the blood-filled, beating-heart model.

Dates et versions

hal-03484249 , version 1 (16-12-2021)

Identifiants

Citer

Benoît Rosa, Zurab Machaidze, Margherita Mencattelli, Sunil Manjila, Borami Shin, et al.. Cardioscopically-guided beating heart surgery: paravalvular leak repair. Annals of Thoracic Surgery, 2017, 104 (3), ⟨10.1016/j.athoracsur.2017.03.028⟩. ⟨hal-03484249⟩
14 Consultations
0 Téléchargements

Altmetric

Partager

More