This Article Full Text Full Text (PDF) On-line Video Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Antonio F. Corno Junqing Zhou Piergiorgio Tozzi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Corno, A. F. Articles by von Segesser, L. K. Search for Related Content PubMed PubMed Citation Articles by Corno, A. F. Articles by von Segesser, L. K. Related Collections Congenital - acyanotic Congenital - cyanotic Congestive Heart Failure

Off-bypass implantation of a self-expandable valved stent between inferior vena cava and right atrium

^a Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
^b Cardiothoracic Department, The No.1 People's Hospital of Shaoxing, Zhejiang, People's Republic of China

^* Corresponding author. Tel.: +41-21-314-2280; fax: +41-21-314-2278
antonio.corno{at}chuv.hospvd.ch

A glutaraldehyde preserved valved bovine jugular xenograft mounted in a nitinol ‘Z’ stent, expandable from 7 to 28mm of internal diameter, was evaluated in vitro (column of water developing a pressure of 45mmHg and a mock loop including a pulsatile pump) and in vivo in five adult pigs with intra-vascular ultrasound to measure the inferior vena cava diameter via a retroperitoneal access. Through a stent-graft delivery system (24 French) the self expandable valved stent was implanted off-bypass in the inferior vena cava, between hepatic veins and cavo-atrial junction, with flow and pressure gradient recording. The mean length of the valved stent was 22.80±1.06mm, the mean internal diameter 20.97±0.5mm and the mean external diameter 26.67±0.9mm. The valve leaking under pressure was 32.5±12.3ml/min. The mean pressure gradient recorded across the self expandable valved stent implanted in the inferior vena cava was 1.0±0.5mmHg (range 0–2mmHg). Intra-vascular ultrasound showed partial opening and closing of the valve (mean area reduction from 148.5 to 81.5mm²), with almost complete occlusion only during deep breaths. The in vitro and in vivo experiments confirmed the feasibility of potential application of the self-expandable valved stent implanted off-bypass in the inferior vena cava for late conversion of failing total cavo-pulmonary connection; intra-vascular ultrasound allows for adequate implantation and evaluation.

Key Words: Biological valved conduits; Cavo-pulmonary connection; Fontan circulation; Inferior vena cava; Off-bypass valve implantation; Right heart failure

This article has been cited by other articles:

				S. Agarwal, E. M. Tuzcu, E. R. Rodriguez, C. D. Tan, L. L. Rodriguez, and S. R. Kapadia Interventional Cardiology Perspective of Functional Tricuspid Regurgitation Circ Cardiovasc Interv, December 1, 2009; 2(6): 565 - 573. [Full Text] [PDF]

				L. K. von Segesser, B. Marty, P. Tozzi, and P. Ruchat Impact of endoluminal stenting for aortic surgery Eur. J. Cardiothorac. Surg., December 1, 2004; 26(Suppl_1): S14 - S18. [Abstract] [Full Text] [PDF]

				L. K. von Segesser Direct percutaneous valve replacement: the next step? Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 873 - 874. [Full Text] [PDF]