Significance of spatial orientation of percutaneously placed bioprosthetic venous valves in an ovine model

Dusan Pavcnik, John A. Kaufman, Barry T. Uchida, Brian Case, Luiz O. Correa, Ahmet Yigit Goktay, Ayumi Hamada, Frederick S. Keller, Josef Rösch

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Abstract

PURPOSE: To investigate two spatial orientations of a percutaneously placed bicuspid second-generation bioprosthetic venous valve (SG-BVV) in the jugular vein (JV). MATERIALS AND METHODS: Twelve SG-BVVs, consisting of small intestinal submucosa attached to a nitinol frame were placed across a natural valve (NV) in the distal JV in six sheep. Six SG-BVVs were oriented as NV leaflets (group A) and the other six SG-BVVs were rotated 90° to NV leaflets (group B). SG-BVV function was studied by venography performed immediately after placement and at 5 weeks after placement. Animals were killed at 5 weeks, and gross examinations were performed. RESULTS: Desired valve orientation after deployment was seen in all SG-BVVs. In group A, all valves exhibited good valve function on immediate and 5-week venography. At gross examination, leaflets were attached mostly at the valve base and free cusp areas were similar in both cusps with a mean of 154.8 mm2 ± 45.6 for one cusp and 142 mm2 ± 53.4 for the other cusp (P = .188). In group B, all valves showed good function on immediate venography and in five valves prior to killing. Valve attachment to the vein wall in this group involved a longer segment of leaflets and their free areas were smaller with a wide variety of cusp sizes. Mean free leaflet areas of opposing cusps measured 106.3 mm2 ± 36.5 and 66.1 mm2 ± 34.6, respectively (P = .025). Difference in leaflet areas between group A and group B was significant (P = .019). CONCLUSION: Proper spatial orientation of the SG-BVV at deployment is important for valve function and should have the same orientation as the NV.

Original languageEnglish (US)
Pages (from-to)1511-1516
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume16
Issue number11
DOIs
StatePublished - Nov 2005

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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