经皮肺动脉瓣置换动物实验研究

目的 探讨新型带瓣膜雕刻支架经皮植入置换肺动脉瓣的可行性和疗效.方法 自行设计圆柱状网状支架,用医用316 L不锈钢激光雕刻而成.将新鲜的猪心包经脱细胞处理后置0.6%戊二醛浸泡36 h,生理盐水洗净,裁剪成人工瓣膜,缝合在不锈钢支架上,制成带瓣膜肺动脉支架.手术前将带瓣膜支架压缩至定制的相应大小的球囊导管上.选择健康犬8只,体重(15.5 ± 3.1)kg,穿刺右股静脉,将带瓣膜支架经导管植入至肺动脉瓣处,置换自身肺动脉瓣膜.手术后通过DSA和超声等方法即刻观察实验效果.结果 1只犬死于术中麻醉意外,7只犬经皮瓣膜置换术均获得成功,术后即时影像和超声检查结果表明人工肺动脉瓣膜功能正常.结论 自制新型带瓣膜支架经导管植入置换肺动脉瓣方法可行,效果理想.

Percutaneous pulmonary valve replacement: an experimental study in dogs

Objective To evaluate the feasibility and efficacy of percutaneous transcatheter implantation of a new-type stainless steel valved stent to replace the original pulmonary valve in dogs. Methods A new cylindrical valved stent was designed by the authors,which was made of 316L stainless steel.Porcine pericardium was manually sutured to the stainless steel stent.The valved stent was compressed on a balloon catheter and was pulled into a 14-French sheath.Percutaneous transcatheter implantation of the valved stent via the femoral vein access was performed in eight healthy dogs to replace their own pulmonary valves.Immediately after the treatment DSA and echocardiography were performed to check the results and to observe the cardiac hemodynamic changes.Results Percutaneous transcatheter implantation of the valved stent via the femoral vein access was successfully accomplished in seven dogs,and one dog died because of anesthesia accident.DSA and echocardiography performed immediately after the implantation procedure showed that the valved stent was in a perfect position with excellent functioning in all seven dogs.Conclusion Percutaneous transcatheter implantation of the self-prepared new-type stainless steel valved stent to replace the original pulmonary valve of the experimental dogs is feasible,safe and effective.