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Abstracts: ASAIO Cardiac Abstracts

DEVICE AND PROCEDURE TO PARTITION THE PRESSURE GENERATED BY TRICUSPID REGURGITATION FROM THE LOWER ORGANS

Quijano, R C1; Thyagarajan, K1; McCarthy, P2; Zhang, J3

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Background.

Severe Tricuspid valve regurgitation (TR), impacts patient’s life style. Surgical repair for patients reaching late stage carries a high mortality. A concept for a device to block retrograde pressure to the Inferior vena cava (IVC) and superior vena cava (SVC) and lower organs is presented.

Experimental Methods.

Moderate to severe TR was induced in 20 sheep by a jugular percutaneous approach severing the tricuspid valve chordal mass. Pressure was measured by means of Swanz-Ganz catheter. Following TR conditioning for 10 weeks, the animals were divided into: I) control, TR only (n=6); II) (n=6) Percutaneous placement of self-expanding valved stent in the IVC and; III) valved stents in both IVC and SVC (n=7). Descending and ascending venograms showed competency and patency of these devices respectively. End points of safety: no migration, no thrombosis and no dissection of the veins. End points of efficacy: containment of Right Heart pressure above the hepatic veins, function of the valve with the cardiac rhythm.

Results:

Preliminary results showed that the device met all the safety end points. Pressure measurements showed partiioning of pressure as compared with the control animals. While in normal animals IVC valve diameters averaged 18–20 mm, those with sustained TR averaged 24–26mm. For animals that also received SVC valved stents increase was approximately 2 mm from an initial 18 mm diameter.

Conclusions:

Deployment of valved stents can be done safely.

Copyright © 2005 by the American Society for Artificial Internal Organs