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Original Articles: Adult Cardiac

Transapical Mitral Valved Stent Implantation

^a Department of Cardiothoracic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
^b Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany

Accepted for publication May 15, 2008.

^_* Address correspondence to Dr Lutter, Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany D-24105 (Email: lutter{at}kielheart.uni-kiel.de).

Background: Transcatheter aortic and pulmonary valve replacement is currently being tested in human trials. Efforts to create a valved stent to replace the atrioventricular valves have shown limited success. This is due to their their complex anatomy and function.

Methods: A self-expanding valved stent was created for transapical replacement of the atrioventricular valve. Ten pigs underwent transapical off-pump mitral valved stent implantation. Data were gathered to assess the animals' hemodynamic stability for 60 minutes after implantation. The valved stent function was assessed by transesophageal echocardiography (TEE) and contrast left ventriculogram.

Results: All animals exhibited normal hemodynamics immediately after mitral valved stent implantation and maintained stability for the entire period of monitoring. Accurate positioning of the valved stent was established in all animals. Mild paravalvular regurgitation was found in three out of ten animals by TEE and in two animals during left ventriculogram. No left ventricular outflow tract obstruction was encountered.

Conclusions: Transapical off-pump mitral valved stent implantation is feasible in an acute experimental setting. Long-term function of the new valved stent remains to be established.

This article has been cited by other articles:

				R. H. Bombien, M. Appel, T. Attmann, G.-R. Klaws, M. Schunke, C. Hass, J. Cremer, and G. Lutter Percutaneous aortic valve replacement: gross anatomy and histological findings after transapical and endoluminal resection of human aortic valves in situ Eur. J. Cardiothorac. Surg., July 1, 2009; 36(1): 112 - 117. [Abstract] [Full Text] [PDF]

				G. Lutter, R. Quaden, S. Osaki, J. Hu, J. Renner, N. M. Edwards, J. Cremer, and L. Lozonschi Off-pump transapical mitral valve replacement Eur. J. Cardiothorac. Surg., July 1, 2009; 36(1): 124 - 128. [Abstract] [Full Text] [PDF]

				J.-B. Masson and J. G. Webb Percutaneous Treatment of Mitral Regurgitation Circ Cardiovasc Interv, April 1, 2009; 2(2): 140 - 146. [Full Text] [PDF]