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Sutureless replacement of aortic valves with St Jude Medical mechanical valve prostheses and Nitinol attachment rings: feasibility in long-term (90-day) pig experiments

Eric Berreklouw, Bart Koene, Filip De Somer UGent, STEFAAN BOUCHEZ UGent, Koen Chiers UGent, Yvo Taeymans UGent and Guido Van Nooten UGent (2011) JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY. 141(5). p.1231-U180
abstract
Objective: Nitinol attachment rings (devices) used to attach mechanical aortic valve prostheses suturelessly were studied in long-term (90 days) pig experiments. Methods: The aortic valve was removed and replaced by a device around a St Jude Medical mechanical valve prosthesis in 10 surviving pigs. Supravalvular angiography was done at the end of the operation. No coumarin derivates were given. Results: No or minimal aortic regurgitation was confirmed in all surviving pigs at the end of the operation. Total follow-up was 846 days. In 4 pigs, follow-up was shorter than 90 days (28-75 days); the other 6 pigs did reach 90 days' survival or more. Repeat angiography in 4 pigs at the end of follow-up confirmed the unchanged position of the device at the aortic annulus, without aortic regurgitation. At autopsy, in all pigs the devices proved to be well grown in at the annulus, covered with endothelium, and sometimes tissue overgrowth related to not using coumarin derivates. There was no case of para-device leakage, migration, or embolization. No damage to surrounding anatomic structures or prosthetic valves was found. Conclusions: Nitinol attachment rings can be used to replace the aortic valve suturelessly with St Jude Medical mechanical aortic valve prostheses, without para-device leakage, migration, or damage to the surrounding tissues, in long-term pig experiments during a follow-up of 90 days or more. Refraining from anticoagulation in pigs with mechanical valve prostheses can lead to tissue overgrowth of the valve prosthesis. Further studies are needed to determine long-term feasibility of this method in human beings.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
HEART-VALVES, IMPLANTATION, STENOSIS, EXPERIENCE, MULTICENTER
journal title
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
J. Thorac. Cardiovasc. Surg.
volume
141
issue
5
pages
1231 - U180
Web of Science type
Article
Web of Science id
000289546100028
JCR category
SURGERY
JCR impact factor
3.406 (2011)
JCR rank
14/198 (2011)
JCR quartile
1 (2011)
ISSN
0022-5223
DOI
10.1016/j.jtcvs.2010.07.014
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1909221
handle
http://hdl.handle.net/1854/LU-1909221
date created
2011-09-27 13:10:42
date last changed
2011-09-27 14:08:23
@article{1909221,
  abstract     = {Objective: Nitinol attachment rings (devices) used to attach mechanical aortic valve prostheses suturelessly were studied in long-term (90 days) pig experiments. 
Methods: The aortic valve was removed and replaced by a device around a St Jude Medical mechanical valve prosthesis in 10 surviving pigs. Supravalvular angiography was done at the end of the operation. No coumarin derivates were given. 
Results: No or minimal aortic regurgitation was confirmed in all surviving pigs at the end of the operation. Total follow-up was 846 days. In 4 pigs, follow-up was shorter than 90 days (28-75 days); the other 6 pigs did reach 90 days' survival or more. Repeat angiography in 4 pigs at the end of follow-up confirmed the unchanged position of the device at the aortic annulus, without aortic regurgitation. At autopsy, in all pigs the devices proved to be well grown in at the annulus, covered with endothelium, and sometimes tissue overgrowth related to not using coumarin derivates. There was no case of para-device leakage, migration, or embolization. No damage to surrounding anatomic structures or prosthetic valves was found. 
Conclusions: Nitinol attachment rings can be used to replace the aortic valve suturelessly with St Jude Medical mechanical aortic valve prostheses, without para-device leakage, migration, or damage to the surrounding tissues, in long-term pig experiments during a follow-up of 90 days or more. Refraining from anticoagulation in pigs with mechanical valve prostheses can lead to tissue overgrowth of the valve prosthesis. Further studies are needed to determine long-term feasibility of this method in human beings.},
  author       = {Berreklouw, Eric and Koene, Bart and De Somer, Filip and BOUCHEZ, STEFAAN and Chiers, Koen and Taeymans, Yvo and Van Nooten, Guido},
  issn         = {0022-5223},
  journal      = {JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY},
  keyword      = {HEART-VALVES,IMPLANTATION,STENOSIS,EXPERIENCE,MULTICENTER},
  language     = {eng},
  number       = {5},
  pages        = {1231--U180},
  title        = {Sutureless replacement of aortic valves with St Jude Medical mechanical valve prostheses and Nitinol attachment rings: feasibility in long-term (90-day) pig experiments},
  url          = {http://dx.doi.org/10.1016/j.jtcvs.2010.07.014},
  volume       = {141},
  year         = {2011},
}

Chicago
Berreklouw, Eric, Bart Koene, Filip De Somer, STEFAAN BOUCHEZ, Koen Chiers, Yvo Taeymans, and Guido Van Nooten. 2011. “Sutureless Replacement of Aortic Valves with St Jude Medical Mechanical Valve Prostheses and Nitinol Attachment Rings: Feasibility in Long-term (90-day) Pig Experiments.” Journal of Thoracic and Cardiovascular Surgery 141 (5): 1231–U180.
APA
Berreklouw, E., Koene, B., De Somer, F., BOUCHEZ, S., Chiers, K., Taeymans, Y., & Van Nooten, G. (2011). Sutureless replacement of aortic valves with St Jude Medical mechanical valve prostheses and Nitinol attachment rings: feasibility in long-term (90-day) pig experiments. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 141(5), 1231–U180.
Vancouver
1.
Berreklouw E, Koene B, De Somer F, BOUCHEZ S, Chiers K, Taeymans Y, et al. Sutureless replacement of aortic valves with St Jude Medical mechanical valve prostheses and Nitinol attachment rings: feasibility in long-term (90-day) pig experiments. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY. 2011;141(5):1231–U180.
MLA
Berreklouw, Eric, Bart Koene, Filip De Somer, et al. “Sutureless Replacement of Aortic Valves with St Jude Medical Mechanical Valve Prostheses and Nitinol Attachment Rings: Feasibility in Long-term (90-day) Pig Experiments.” JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 141.5 (2011): 1231–U180. Print.