Back to ISMICS Main Site
   Home
   Housing
Days left until Meeting:
0 0 -


 



Back to Annual Meeting Posters


IMAGING AND ASSESSMENT DURING EXPERIMENTAL MITRAL VALVED STENT IMPLANTATION
Katharina Huenges1, Saskia Pokorny1, Telse Bähr1, Huang D. Dai1, Florian Bönke1, Lucian Lozonschi2, Jochen Cremer1, Georg Lutter1.
1University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, 2University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA.

OBJECTIVE: In course of the recent developments of various catheter-based technologies, the demands on imaging techniques become more critical. In this study we report our experiences in experimental off-pump mitral valved stent implantation focused on guidance and assessment using a combination of different imaging techniques.
METHODS: Transapical mitral valved stent implantation in the beating heart was performed in 10 pigs under 3DTEE and 2DTEE guidance. TEE was conducted to evaluate the heart function before, and the valved stent position and performance after implantation. After one month cardiac CT was performed to evaluate stent formation and position. Cardiac catheterization was utilized to evaluate performance and paravalvular leakage (PVL).
RESULTS: Ten animals were implanted successfully and were followed-up for one month. 3DTEE provided dependable spatial visualization of the left heart,mitral apparatus, delivery system, and valved stent (Fig.A). It was an adequate method for correct positioning of the stent. Disadvantage of this technique were the strong artefacts caused by the metal frame, shadowing the structures beyond the stent.
Cardiac catheterization and contrast angiography proofed to be of explicit value to evaluate global pump function, regurgitation, PVL and hemodynamics (Fig.B). It provided more reliable results on the impact of the stent on the heart function compared to the TEE, in particular judging the combined central and PVL.
Cardiac CT provided quantitative information on the stent positioning and shaping in the beating heart (Fig.C). These results are of great value to optimize the prototypes. In future, CT-based evaluation of the mitral valve apparatus will be important for preoperative stent sizing.
CONCLUSIONS: The development of real time 3DTEE is of great value and 2DTEE enables an accurate and quantitative evaluation. Drawback is the sound cancellation beyond the valved stent. Angiography is very beneficial for an overall judgment of heart function. This is of particular importance in the follow up examinations. Choosing the optimal imaging technique and particularly a combination optimizes the results, not solely in experimental developments.


Back to Annual Meeting Posters

 



© 2024 International Society for Minimally Invasive Cardiothoracic Surgery. All Rights Reserved. Read Privacy Policy.