Author/Editor		Pavčnik, Dušan; Kaufman, John; Uchida, Barry; Correa, Luiz; Hiraki, Takao; Kyu, Seong Chang; Keller, Frederick S; Rosch, Josef
Title		Second-generation percutaneous bioprosthetic valve: a short-term study in sheep
Type		članek
Source		J Vasc Surg
Vol. and No.		Letnik 40, št. 6
Publication year		2004
Volume		str. 1223-7
Language		eng
Abstract		Objectives: To eliminate occasional tilting of the original bioprosthetic venous valve (BVV) a second-generation BVV has been developed. This study was performed to evaluate deployment, stability, and short-term function of the second-generation BVV in an animal model. Methods: A second-generation percutaneously placed BVV consisting of a square stent and lyophilized small intestinal submucosa attached to a second square stent (DS BVV) or Z-stent (ZS BVV) were tested. DS BVVs (n = 32) were constructed with a nitinol (n = 28) or stainless steel double stent (n = 4), and ZS BVVs (n = 16) were made of nitinol (n = 8) or stainless steel (n = 4). BVVs were implanted percutaneously through a femoral vein approach into the jugular vein in 24 female sheep with an over-the-wire 13F or 10F delivery system. All BVVs were placed across the natural valve of the proximal jugular vein. Deployment, stability, and function of BVVs were studied at immediate venography with contrast medium injections peripheral and central to the BVVs. Animals underwent follow-up venography and were sacrificed at 6 weeks (n = 24). Gross pathologic examination was performed. Results: Jugular vein diameter ranged from 9.8 to 14.4 mm (mean, 12.1 +/- 1.2 mm) in 24 sheep. The 10-mm to 12-mm valve was deployed in 27 jugular veins, and the 12-mm to 14-mm valve was deployed in 21 jugular veins. No tilting was seen at placement of 48 BVVs into the jugular veins, and all valves exhibited good function on immediate venograms. Angiographic competency for the nitinol and stainless steel ZS BVV (100%) was similar to that for the nitinol DS BVV (92.3%; P = .488) but was significantly better than for the stainless steel DS BVV at 6 weeks (50%; P = .03). Dysfunction of 4 valves was caused by either nitinol DS BVV oversizing (n = 2) or intimal hyperplasia with the stainless steel DS BVV (n = 2). Conclusion: Placement without tilting appears essential for proper valve function. (Abstract truncated at 2000 characters)
Descriptors		BIOPROSTHESIS BLOOD VESSEL PROSTHESIS PROSTHESIS FAILURE ANIMALS CATHETERIZATION SHEEP STENTS