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Home / Equine Research Bank / Circulation / Percutaneous aortic valve implantation retrograde from the f...
Circulation2006; 113(6); 842-850; doi: 10.1161/CIRCULATIONAHA.105.582882

Percutaneous aortic valve implantation retrograde from the femoral artery.

Abstract: Percutaneous aortic valve implantation by an antegrade transvenous approach has been described but is problematic. Retrograde prosthetic aortic valve implantation via the femoral artery has potential advantages. Percutaneous prosthetic aortic valve implantation via the femoral arterial approach is described and the initial experience reported. Results: The valve prosthesis is constructed from a stainless steel stent with an attached trileaflet equine pericardial valve and a fabric cuff. After routine aortic balloon valvuloplasty, a 22F or 24F sheath is advanced from the femoral artery to the aorta. A steerable, deflectable catheter facilitates manipulation of the prosthesis around the aortic arch and through the stenotic valve. Rapid ventricular pacing is used to reduce cardiac output while the delivery balloon is inflated to deploy the prosthesis within the annulus. Percutaneous aortic prosthetic valve implantation was attempted in 18 patients (aged 81+/-6 years) in whom surgical risk was deemed excessive because of comorbidities. Iliac arterial injury, seen in the first 2 patients, did not recur after improvement in screening and access site management. Implantation was successful in 14 patients. After successful implantation, the aortic valve area increased from 0.6+/-0.2 to 1.6+/-0.4 cm2. There were no intraprocedural deaths. At follow-up of 75+/-55 days, 16 patients (89%) remained alive. Conclusions: This initial experience suggests that percutaneous transarterial aortic valve implantation is feasible in selected high-risk patients with satisfactory short-term outcomes.
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Publication Date: 2006-02-06 PubMed ID: 16461813DOI: 10.1161/CIRCULATIONAHA.105.582882Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article is about the procedure and initial results of percutaneous aortic valve implantation by a retrograde approach, through the femoral artery.

Introduction to Percutaneous Aortic Valve Implantation

  • The article highlights the percutaneous aortic valve implantation procedure, which is carried out via the femoral artery as opposed to the antegrade transvenous approach, which has been deemed problematic.
  • This procedure allows a prosthetic aortic valve to be implanted in patients who have high surgical risk due to comorbidities.
  • The purpose of this study was to describe this procedure and report on their initial experience with it.

The Valve Prosthesis

  • The heart valve prosthesis used is assembled from a stainless steel stent, a trileaflet equine pericardial valve, and a fabric cuff.
  • It is implanted post a routine aortic balloon valvuloplasty, where a 22F or 24F sheath is advanced from the femoral artery to the aorta.
  • A steerable, deflectable catheter is used for the manipulation of the prosthesis around the aortic arch and through the stenotic valve.
  • Rapid ventricular pacing is employed to decrease cardiac output while the delivery balloon is inflated to deploy the prosthesis within the annulus.

Issued and Results

  • The procedure was attempted on 18 patients, aged 81+/-6 years, who were considered high risk for surgery due to their existing health issues.
  • Initial complications were seen with the first two patients suffering iliac arterial injury. However, after improving screening and access site management, this issue did not recur.
  • The implantation was successful in 14 patients, after which the aortic valve area increased from 0.6+/-0.2 to 1.6+/-0.4 cm².
  • There were no deaths during the procedure, and a follow up after 75+/-55 days showed that 16 patients (89%) were still alive.

Conclusion

  • The initial experiment showed that percutaneous transarterial aortic valve implantation could be a feasible option for high-risk patients.
  • The short-term results were satisfactory, but the conclusion recommends further studies to understand long-term outcomes and stability.

Cite This Article

APA
Webb JG, Chandavimol M, Thompson CR, Ricci DR, Carere RG, Munt BI, Buller CE, Pasupati S, Lichtenstein S. (2006). Percutaneous aortic valve implantation retrograde from the femoral artery. Circulation, 113(6), 842-850. https://doi.org/10.1161/CIRCULATIONAHA.105.582882

Publication

Circulation
ISSN: 1524-4539
NlmUniqueID: 0147763
Country: United States
Language: English
Volume: 113
Issue: 6
Pages: 842-850

Researcher Affiliations

Webb, John G
  • Division of Cardiology, St. Paul's Hospital, Vancouver, British Columbia, Canada. webb@providencehealth.bc.ca
Chandavimol, Mann
    Thompson, Christopher R
      Ricci, Donald R
        Carere, Ronald G
          Munt, Brad I
            Buller, Christopher E
              Pasupati, Sanjeevan
                Lichtenstein, Samuel

                  MeSH Terms

                  • Aged
                  • Aged, 80 and over
                  • Animals
                  • Aortic Valve
                  • Bioprosthesis
                  • Catheterization / instrumentation
                  • Equipment Design
                  • Female
                  • Femoral Artery
                  • Heart Valve Prosthesis
                  • Heart Valve Prosthesis Implantation / instrumentation
                  • Heart Valve Prosthesis Implantation / methods
                  • Horses
                  • Humans
                  • Male
                  • Treatment Outcome

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