Transcatheter artificial aortic valve implantation: animal experiment and image analysis

AIM: To establish a new method of transcatheter aortic valve implantation, to determine the optimal projecting position for the angiography of aortic sinus and to explore the feasibility and safety of this method. METHODS: Ten healthy hybrid pigs were enrolled in this study. A pigtail catheter was placed in the left ventricle through the right femoral artery for ventriculography. The optimal projection position was determined and the diameter of the aortic sinus was measured after left ventriculography. A temporary pacemaker electrode was placed in the right ventricle and the appropriate pacing frequency was selected. A 22F delivery catheter was inserted in the abdominal aorta and a balloon catheter mounted with an artificial valve stent was attempted to be pushed and pulled through the delivery catheter system. RESULTS: Aortic sinus and coronary artery were well demonstrated in the left anterior oblique position (30±2°) plus cranial (10±4°). The diameter of the aortic sinus was (212±23) mm. All pigs enrolled in this study safely endured a rapid pacing frequency (240-260/min) for ~30 sec. CONCLUSION: Implantation of artificial aortic valves through the abdominal aorta is feasible and safe. Aortic sinus and coronary artery are well demonstrated in the left anterior oblique position (30±2°) plus cranial (10±4°). Under the condition of right ventricular rapid pacing, the valve stent could be more accurately implanted into position and the impact of blood flow could be maximally decreased.