Department of Cardiovascular Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, China.
Department of Cardiovascular Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, China.
Int J Cardiol. 2020 Nov 15;319:120-126. doi: 10.1016/j.ijcard.2020.06.070. Epub 2020 Jul 4.
Interventional treatments of tricuspid regurgitation have been emerging as minimally invasive alternatives. Among those reported transcatheter tricuspid devices, the radial force between the device and native tricuspid annulus is the common principle to be employed for device immobilization. However, this immobilization mechanism may potentially lead to adverse consequences. We developed a radial force-independent stent valve device for implantation at native tricuspid annular site without inducing stress on either myocardial tissue or the bioprosthesis.
We designed a radial force-independent LuX-Valve as a transcatheter bioprosthesis, comprising a stent valve and a delivery system. The device employs a combination of a right ventricle anchoring component, two leaflet-grasping clips, and an atrial disc as a mechanical integrity to immobilize the stent valve device in secure at the native tricuspid annulus. We evaluated the feasibility and safety of implantation of this device in a goat model.
We successfully implanted LuX-Valves at the tricuspid position through the right atrium in 17 goats. Procedures in 16 cases were safe. Time for the operator to implant the device until immobilization in secure ranged from 3.5 to 10 min. No significant paravalvular leakage was detected by echocardiography during follow-up, up to 180 days. Histopathology showed no evidence of stent fracture and myocardial injury.
The results indicated that radial force-independent LuX-Valve was safe and practicable for tricuspid valve implantation with satisfactory prosthetic function.
介入性三尖瓣反流治疗已成为微创治疗的替代方法。在已报道的经导管三尖瓣装置中,装置和原生三尖瓣环之间的径向力是用于装置固定的共同原理。然而,这种固定机制可能会导致不良后果。我们开发了一种径向力独立的支架瓣膜装置,用于植入原生三尖瓣环部位,而不会对心肌组织或生物假体造成任何压力。
我们设计了一种径向力独立的 LuX-Valve 作为经导管生物假体,包括支架瓣膜和输送系统。该装置采用右心室锚固组件、两个瓣叶夹和一个心房盘的组合,以机械完整性固定支架瓣膜装置,使其安全地固定在原生三尖瓣环上。我们在山羊模型中评估了该装置植入的可行性和安全性。
我们成功地在 17 只山羊的右心房通过右心房将 LuX-Valve 植入三尖瓣位置。16 例手术均安全。从装置植入到固定的时间范围为 3.5 至 10 分钟。在 180 天的随访中,超声心动图未发现明显的瓣周漏。组织病理学检查未见支架断裂和心肌损伤。
结果表明,径向力独立的 LuX-Valve 用于三尖瓣植入是安全可行的,具有令人满意的假体功能。