Antegrade Transapical Branched Aortic Arch Endograft - a Feasibility Study in Pigs

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Erscheinungsjahr:
2013
Medientyp:
Text
Beschreibung:
  • Background: To describe the technique and proof the concept of a complete transapical deployment of a single sidebranch arch endograft in a porcine model.
    Methods: Eight domestic pigs were operated with antegrade transapical delivery of a single-sidebranch arch endograft including a mating stentgraft to the innominate artery. Technical feasibility, operating time, radiation parameters and hemodynamic changes were studied according to standardized protocol during baseline (T0), after establishing of the transapical access and through-and-through wire (T1) and after stent-graft deployment (T2). Myocardial and cerebral Perfusion were assessed by fluorescent-microspheres (FM) and transit-time-flow measurement (TTFM).
    Results: Transapical access, introduction and deployment of the endograft, sidebranch catheterization and deployment of the mating stent-graft were feasible in 6 of the 8 animals with unimpeded perfusion of the innominate artery. One animal was lost during transapical access, one during sire-branch catheterization. The mean operating and fluoroscopy times were 15747min and 15.93.2min. During introduction and deployment of the stent-graft transient aortic valve insufficiency occurred in all animals. Hemodynamic stability recovered within ten minutes after retrieval of the delivery system in all animals. The innominate artery was patent with unchanged TTFM-flow measurements throughout the procedure. FM evaluation revealed stable myocardial and cerebral perfusion.
    Conclusions: Antegrade transapical access to the aortic arch for implantation of
    a single sidebranch arch endograft is feasible in a porcine model with reversible
    impact on hemodynamic measures during deployment. Transapical access allows for deployment of a complex endograft through a single large bore access-site in a porcine model. It might be a future treatment option for selective patients.
Lizenz:
  • info:eu-repo/semantics/openAccess
Quellsystem:
Forschungsinformationssystem des UKE

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oai:pure.atira.dk:publications/eea11397-c421-48b7-8125-a535c3153f46