Avtor/Urednik		Pavčnik, Dušan; Yin, Qiang; Uchida, Barry; Park, Won Kyu; Hoppe, Hanno; Kim, Man Duck; Keller, Frederick S; Rösch, Josef
Naslov		Percutaneous autologous venous valve transplantation: short-term feasibility study in an ovine model
Tip		članek
Vir		J Vasc Surg
Vol. in št.		Letnik 46, št. 2
Leto izdaje		2007
Obseg		str. 338-45
Jezik		eng
Abstrakt		Background: Limited experience with bioprosthetic venous valve percutaneously inserted into femoral veins in 15 patients has been promising in short-term results only to show disappointing long-term results. Percutaneous autogenous venous valve (PAVV) transplantation was explored in an ovine model as a possible alternative treatment. Methods: PAVV consisted of a vein segment containing a valve that was attached to a stent template. The stent templates (n = 9) were designed and hand made in our research laboratory. They consist of two stainless steel square stents 13 or 15 mm in diameter to fit the ovine jugular veins (JV), which ranges from 10 to 15 mm in diameter. A valve-containing segment of JV was harvested and attached with sutures and barbs inside the stent template (n = 9). The valve devices were then manually folded and front loaded inside the 4 cm chamber of the 13F delivery sheath and delivered into the contralateral JV by femoral vein approach. Transplanted PAVVs were studied by immediate and 3 months venograms. Animals were euthanized at 3 months, and jugular veins harvested to perform angioscopic evaluations in vitro. Results: PAVV transplantation was successful in all nine animals. Good valve function with no reflux was observed on immediate and 3 months venograms in eight valves. The transplanted maximal JV diameter ranged from 10.2 mm to 15.4 mm (mean 13.1 +/- 1.5 mm). Venoscopic examination revealed intact, flexible, nonthickened valve leaflets in eight specimens. One PAVV exhibited normal function of one leaflet only; the other cusp was accidentally cut during the transplantation procedure. All transplanted autologous valves were free of thrombus and incorporated into the vein wall of the host vessel. Conclusion: This study demonstrated that autogenous valve transplants remained patent and competent without long-term anticoagulation for up to 3 months. (Abstract truncated at 2000 characters)
Deskriptorji		STENTS ANIMALS BIOPROSTHESIS BLOOD VESSEL PROSTHESIS FEASIBILITY STUDIES JUGULAR VEINS MITRAL VALVE PROSTHESIS DESIGN SHEEP TRANSPLANTATION, AUTOLOGOUS VASCULAR PATENCY