Pavcnik Dusan, Kaufman John A, Uchida Barry T, Case Brian, Correa Luiz O, Goktay Ahmet Yigit, Hamada Ayumi, Keller Frederick S, Rösch Josef
Dotter Interventional Institute, Oregon Health & Science University, Portland, Oregon 97239, USA.
J Vasc Interv Radiol. 2005 Nov;16(11):1511-6. doi: 10.1097/01.RVI.0000178251.74190.7D.
To investigate two spatial orientations of a percutaneously placed bicuspid second-generation bioprosthetic venous valve (SG-BVV) in the jugular vein (JV).
Twelve SG-BVVs, consisting of small intestinal submucosa attached to a nitinol frame were placed across a natural valve (NV) in the distal JV in six sheep. Six SG-BVVs were oriented as NV leaflets (group A) and the other six SG-BVVs were rotated 90 degrees to NV leaflets (group B). SG-BVV function was studied by venography performed immediately after placement and at 5 weeks after placement. Animals were killed at 5 weeks, and gross examinations were performed.
Desired valve orientation after deployment was seen in all SG-BVVs. In group A, all valves exhibited good valve function on immediate and 5-week venography. At gross examination, leaflets were attached mostly at the valve base and free cusp areas were similar in both cusps with a mean of 154.8 mm2 +/- 45.6 for one cusp and 142 mm2 +/- 53.4 for the other cusp (P = .188). In group B, all valves showed good function on immediate venography and in five valves prior to killing. Valve attachment to the vein wall in this group involved a longer segment of leaflets and their free areas were smaller with a wide variety of cusp sizes. Mean free leaflet areas of opposing cusps measured 106.3 mm2 +/- 36.5 and 66.1 mm2 +/- 34.6, respectively (P = .025). Difference in leaflet areas between group A and group B was significant (P = .019).
Proper spatial orientation of the SG-BVV at deployment is important for valve function and should have the same orientation as the NV.
研究经皮放置的二代双叶生物人工静脉瓣膜（SG-BVV）在颈静脉（JV）中的两种空间取向。
将12个由附着在镍钛诺框架上的小肠黏膜下层制成的SG-BVV放置在6只绵羊远端颈静脉的天然瓣膜（NV）处。6个SG-BVV按NV瓣叶方向放置（A组），另外6个SG-BVV相对于NV瓣叶旋转90度（B组）。在放置后即刻及放置后5周通过静脉造影研究SG-BVV的功能。5周后处死动物并进行大体检查。
所有SG-BVV在展开后均呈现出预期的瓣膜取向。A组中，所有瓣膜在放置后即刻及5周静脉造影时均表现出良好的瓣膜功能。大体检查时，瓣叶大多附着在瓣膜基部，两个瓣叶的游离瓣尖面积相似，一个瓣叶平均为154.8 mm2±45.6，另一个瓣叶平均为142 mm2±53.4（P = 0.188）。B组中，所有瓣膜在放置后即刻及处死前的5个瓣膜中均显示出良好功能。该组瓣膜与静脉壁的附着涉及更长的瓣叶段，其游离面积较小，瓣尖大小各异。相对瓣叶的平均游离面积分别为106.3 mm2±36.5和66.1 mm2±34.6（P = 0.025）。A组和B组之间瓣叶面积差异显著（P = 0.019）。
SG-BVV在展开时的正确空间取向对瓣膜功能很重要，且应与NV具有相同的取向。
