Zhou Qingling, Teng Fei, Zhang Yongshan, Sun Qiang, Meng Guowei
Department of Cardiovascular Surgery, Second Hospital Affiliated to Shandong University, Jinan, China.
Interact Cardiovasc Thorac Surg. 2018 Aug 1;27(2):295-300. doi: 10.1093/icvts/ivy060.
We assessed the transventricular placement of porcine small intestinal submucosa (SIS) stent valves in a juvenile sheep model at the 3-month follow-up evaluation.
We constructed a pulmonary stent valve by suturing a porcine SIS bicuspid valve into a bell-shaped 'Z' nitinol stent and implanted 7 SIS stent valves transventricularly in the pulmonary position in 7 sheep. The function of the stent valves was assessed using a pulsatile flow simulation system in vitro. Haemodynamic, angiographic, echocardiographic, histologic and radiographic examinations were carried out before, immediately after implantation and 3 months after implantation.
All SIS stent valves were successfully implanted in the pulmonary position in 7 sheep. Angiographic, echocardiographic, haemodyamic and macroscopic studies confirmed firm anchoring and good positioning of the stents immediately after implantation and at 3-month follow-up. All stent valves had good function immediately after implantation and at the end of the protocol, with the exception of 1 stent valve with mild stenosis detected at the end of the protocol. All SIS valves were free of calcifications and thrombus formation, and all stents were intact with no fractures and migration based on postmortem examination and X-radiography.
We demonstrated successful implantation of porcine SIS stent valves in the pulmonary position in sheep with excellent valve function at the 3-month follow-up evaluation. Porcine SIS has potential superiority as a pulmonary stent bioprosthetic valve material, and the bell-shaped nitinol stent has potential superiority as a frame for pulmonary stent valves.
在为期3个月的随访评估中，我们在幼年绵羊模型中评估了猪小肠黏膜下层（SIS）支架瓣膜的经心室置入情况。
我们通过将猪SIS双叶瓣膜缝合到钟形“Z”镍钛诺支架中构建了一个肺动脉支架瓣膜，并将7个SIS支架瓣膜经心室植入7只绵羊的肺动脉位置。在体外使用脉动流模拟系统评估支架瓣膜的功能。在植入前、植入后即刻和植入后3个月进行血流动力学、血管造影、超声心动图、组织学和放射学检查。
所有7只绵羊的肺动脉位置均成功植入了SIS支架瓣膜。血管造影、超声心动图、血流动力学和宏观研究证实，植入后即刻和3个月随访时支架固定牢固且位置良好。除了在实验结束时检测到1个支架瓣膜有轻度狭窄外，所有支架瓣膜在植入后即刻和实验结束时功能良好。根据尸检和X线检查，所有SIS瓣膜均无钙化和血栓形成，所有支架完整，无骨折和移位。
我们证实在绵羊肺动脉位置成功植入了猪SIS支架瓣膜，在3个月的随访评估中瓣膜功能良好。猪SIS作为肺动脉支架生物人工瓣膜材料具有潜在优势，钟形镍钛诺支架作为肺动脉支架瓣膜的框架具有潜在优势。
