Conflict of interest: The coauthors (A.D.K., S.H., B.S., and R.J.) are research consultants to Carag AG Company who manufactured the valve. However, we have no further financial relationship with the company, had full control and freedom of investigation with regards to the design of the study, the methods used, as well as the outcome measurements, data analysis, and the writing of the final manuscript.
Pediatric and Congenital Heart Disease
Minimally invasive insertion of an equine stented pulmonary valve with a built-in sinus portion in a sheep model†
Version of Record online: 8 DEC 2011
Copyright © 2011 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 79, Issue 4, pages 654–658, 1 March 2012
How to Cite
Dodge-Khatami, A., Hallhagen, S., Limacher, K., Söderberg, B. and Jenni, R. (2012), Minimally invasive insertion of an equine stented pulmonary valve with a built-in sinus portion in a sheep model. Cathet. Cardiovasc. Intervent., 79: 654–658. doi: 10.1002/ccd.23354
- Issue online: 17 FEB 2012
- Version of Record online: 8 DEC 2011
- Accepted manuscript online: 22 NOV 2011 02:20PM EST
- Manuscript Accepted: 9 AUG 2011
- Manuscript Revised: 17 JUL 2011
- Manuscript Received: 2 MAR 2011
- Carag AG (Baar, Switzerland)
- animal model;
- heart valve (transapical, percutaneous);
- off-pump surgery;
- pulmonary valve
Objectives: This study evaluated the feasibility of inserting a new equine stented-valve with a sinus portion in a lamb survival model, through a minimally invasive thoracotomy with right ventricular access without cardiopulmonary bypass. Background: Extant surgical or percutaneous methods for inserting biological valves in the right outflow tract have drawbacks and limitations. Methods: A decellularized equine valved jugular vein, sutured to a self-expanding stent with a sinus portion, was placed through a minimal right thoracotomy using a newly developed flexible hydraulic release device in seven lambs. The approach through the right ventricle into the pulmonary valve position is achieved on a beating heart. Results: The stented valves were correctly positioned in the right outflow tract, were competent up to 6 months as confirmed by angiography and echocardiography, and were well-tolerated by the animals, with endothelialization of the valve demonstrated at 6 months. Conclusions: The newly developed hydraulic release system allowed for safe and reliable insertion of an equine stented-valve with a sinus portion, through a right transventricular approach on a beating heart, in a sheep survival model. © 2011 Wiley Periodicals, Inc.