首页|新型经导管三尖瓣介入瓣膜装置的研制与性能测试

新型经导管三尖瓣介入瓣膜装置的研制与性能测试

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目的 研制一种新型经导管三尖瓣介入瓣膜装置并在动物实验中验证其性能.方法 本团队研制的三尖瓣介入支架瓣膜由双层自膨式镍钛合金支架、生物组织牛心包瓣叶、聚四氟乙烯(PTFE)编织物裙边组成.输送装置采用经右心房或颈内静脉介入方式,由手柄控制单元及输送鞘管组成.输送鞘管具有X线下显影特征,手柄控制单元可实现介入瓣膜稳定释放及部分回收的功能.此外,本研究在离体实验的基础上,进行动物存活实验.以大白猪为实验动物,采用正中开胸建立体外循环,切开右心房,在心脏跳动下直视释放介入瓣膜.实验动物饲养1个月后,对介入三尖瓣装置的可操作性和稳固性进行评估.结果 通过活体动物实验,成功释放介入瓣膜,锚定位置及固定效果满意.术后经胸超声心动图提示介入瓣膜开闭良好,三尖瓣流速0.6 m/s,未见明显三尖瓣反流.术后饲养1个月后,解剖发现该介入瓣膜无变形、无移位、瓣叶对合良好,介入瓣膜内外层间的凹槽内有少量血栓附着.结论 初步的动物存活实验证明该装置可稳定、牢固地贴合三尖瓣环,锚定效果好,能够有效减少瓣周漏.
Development and performance testing of a novel transcatheter tricuspid valve interventional device
Objective To develop a novel transcatheter tricuspid valve replacement device and test its performance.Methods The transcatheter tricuspid valve stent consisted of double-layer self-expanding nitinol stent,biotissue-derived bovine pericardial leaflets,and PTFE woven.The delivery system,mainly consisting of a handle control unit and a delivery sheath,was sent to the correct position via right atrium or jugular vein.The sheath had a visualization feature,and the handle control unit could realize the functions of stable release and partial recovery of the interventional valve.In addition,this study performed animal survival experiments on the basis of in vitro experiments.A large-white pig was used as the experimental animal.Cardiopulmonary bypass was established through median thoracotomy,then the right atrium was opened,and the interventional valve was released under direct vision without cardiac arrest.Approximately 1 month after interventional valve implantation,the maneuverability and stability of the interventional tricuspid device were evaluated by autopsy.Results Through the animal experiment,the interventional valve was successfully released,and the anchoring was satisfactory.Postoperative transthoracic echocardiography showed that the interventional valve opened and closed well,the flow rate of tricuspid valve was 0.6 m/s,and there was no obvious tricuspid regurgitation.One month after the operation,we dissected the large-white pig and found the interventional valve was not deformed or displaced,the leaflets were well aligned,and there was thrombus attachment in the groove between the inner and outer layers of the interventional valve.Conclusion Animal experiment shows that the novel device can stably and firmly attach to the tricuspid annulus,with good anchoring effect,and effectively reduce paravalvular leakage.

Tricuspid regurgitationinterventional valvedevice developmentanimal experiments

王秋吉、赵俊飞、钟丽珊、肖硕、张朝龙、汪珍忠、方斗、李玉欣、柯英杰、庞善文、丘俊强、何标川、黄焕雷

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南方医科大学附属广东省人民医院(广东省医学科学院)心外科(广州 510080)

广东省心血管病研究所(广州 510030)

华南理工大学医学院(广州 510006)

广东省人民医院附属南海医院南海区第二人民医院心外科(广东佛山 528000)

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三尖瓣关闭不全 介入瓣膜 装置研制 动物实验

广东省基础与应用基础研究基金

2019B1515120071

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(6)