Author + information
- Received November 6, 2004
- Revision received December 21, 2004
- Accepted January 11, 2005
- Published online July 19, 2005.
- Younes Boudjemline, MD⁎,†,⁎ (, )
- Gabriella Agnoletti, MD⁎,
- Damien Bonnet, MD⁎,†,
- Luc Behr, DVM‡,
- Nicolas Borenstein, DVM‡,
- Daniel Sidi, MD⁎,† and
- Philipp Bonhoeffer, MD§
- ↵⁎Reprint requests and correspondence:
Dr. Younes Boudjemline, Service de Cardiologie Pédiatrique, Hôpital Necker Enfants Malades, 149 Rue de Sévres, 75015 Paris Cedex, France
Objectives The goal of this study was to develop a device for percutaneous replacement of the tricuspid valve in animals.
Background Percutaneous valve replacement has recently been introduced, and early clinical experience has been reported. To date, this technique is limited to the replacement of pulmonary and aortic valves in selected patients.
Methods A newly designed nitinol stent, forming two large disks separated by a cylinder with a diameter of 18 mm, was specially designed for the purpose of this study. An 18-mm bovine valve was mounted in the central part of the stent, and a polytetrafluoroethylene membrane was sutured onto the ventricular disk. Eight ewes were equally divided into two groups (group 1, acute study; group 2, killed at one month).
Results Seven of eight devices were successfully delivered in the desired position. In one animal, the device was trapped in tricuspid cordae, leading to its incomplete opening. A significant paravalvular leak was noticed in one animal of group 2. Mean right atrial pressure increased from 5 to 7 mm Hg and did not change during the follow-up. At autopsy, examination confirmed the good position of devices in successfully implanted animals.
Conclusions Implantation of a semi-lunar valve in the tricuspid position is possible in ewes through a transcatheter approach. A disk-based nitinol stent is needed to allow valve implantation in the atrioventricular position. These studies open new perspectives into tricuspid as well as mitral valve replacement.
Supported by The Fondation de l’Avenir, Paris, France.
- Received November 6, 2004.
- Revision received December 21, 2004.
- Accepted January 11, 2005.
- American College of Cardiology Foundation