Vol. 26 No. 2 (2022)
EXPERIMENTAL STUDIES

The results of the application of a new technique of open implantation of self-opening transcatheter aortic valves in an experiment

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  • M.O. Zhulkov,
  • K.V. Kozyr,
  • I.S. Zykov,
  • A.R. Tarkova,
  • H.A. Agaeva,
  • A.K. Sabetov,
  • D.A. Sirota,
  • D.S. Sergeevichev,
  • A.M. Chernyavskiy
M.O. Zhulkov
Meshalkin National Medical Research Center, Novosibirsk
Bio
K.V. Kozyr
Meshalkin National Medical Research Center, Novosibirsk
I.S. Zykov
Meshalkin National Medical Research Center, Novosibirsk
A.R. Tarkova
Meshalkin National Medical Research Center, Novosibirsk
H.A. Agaeva
Meshalkin National Medical Research Center, Novosibirsk
A.K. Sabetov
Meshalkin National Medical Research Center, Novosibirsk
D.A. Sirota
Meshalkin National Medical Research Center, Novosibirsk
D.S. Sergeevichev
Meshalkin National Medical Research Center, Novosibirsk
A.M. Chernyavskiy
Meshalkin National Medical Research Center, Novosibirsk
Этап укрепления аортального фиброзного кольца
DOI: https://doi.org/10.21688/1681-3472-2022-2-49-57

Published 2022-06-30

Keywords

  • aortic valve,
  • aortic valve stenosis,
  • heart valve prosthesis,
  • minimally invasive surgery,
  • transcatheter aortic valve replacement

How to Cite

Zhulkov, M., Kozyr, K., Zykov, I., Tarkova, A., Agaeva, H., Sabetov, A., Sirota, D., Sergeevichev, D., & Chernyavskiy, A. (2022). The results of the application of a new technique of open implantation of self-opening transcatheter aortic valves in an experiment. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 26(2), 49–57. https://doi.org/10.21688/1681-3472-2022-2-49-57

Copyright (c) 2022 Zhulkov M.O., Kozyr K.V., Zykov I.S., Tarkova A.R., Agaeva H.A., Sabetov A.K., Sirota D.A., Sergeevichev D.S., Chernyavskiy A.M.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Background. In recent years, transcatheter implantation of the aortic valve has become increasingly performed as an alternative to "open" prosthetics. The undoubted advantage of this technology is its minimally invasive nature, which in most cases provides a favorable clinical outcome of the intervention. The transcatheter method of aortic valve prosthetics does not require sternotomy and connection of an artificial circulation device, which significantly reduces the risk of postoperative mortality and complications. However, despite all the advantages of the existing models, they are not without drawbacks that force researchers to develop and test new transcatheter valves. The problem of experimental studies of new models of self-opening transcatheter aortic valves is mainly determined by the anatomical features of the aortic root of animals. In this regard, the development of a reliable method of implantation of valve prostheses in the experiment is an urgent problem of preclinical testing.
Aim. Development of a protocol for open implantation of a transcatheter aortic valve in experiment and evaluation of long-term results.
Methods. To develop an experimental model, pigs of the "Landras" breed, females weighing 129.83 ± 9 kg were used. Transcatheter aortic valve implantation was performed under conditions of artificial circulation and moderate hypothermia (33-34°C) through a transverse aortotomy under the control of vision. During the experiment, invasive monitoring of blood pressure, central venous pressure, heart rhythm, body temperature, blood gas composition, activated clotting time was performed. The correct positioning and hemodynamic parameters after implantation were evaluated using transesophageal echocardiography.
Results. In a series of chronic experiments, 18 open implantations of self-opening transcatheter aortic valves were performed. Successful positioning was achieved in 100% of cases. The developed protocol of open implantation made it possible to achieve reliable fixation of the prosthesis in the orthotopic position, as well as to prevent the migration of the prosthesis, the development of mitral regurgitation, paraaortic fistulas and coronary circulation disorders.
Conclusion. In the course of the study, a simple and effective method of open implantation of a transcatheter aortic heart valve prosthesis was developed in an experiment.

Received 1 October 2021. Revised 1 November 2021. Accepted 12 November 2021.

Funding: This work was carried out within the framework of the state task of Ministry of Health of Russian Federation No. 121032300337-5.

Conflict of interest: Authors declare no conflict of interest.

Contribution of the authors
Conception and study design: M.O. Zhulkov, D.A. Sirota, K.V. Kozyr, D.S. Sergeevichev
Data collection and analysis: M.O. Zhulkov
Drafting the article: M.O. Zhulkov
Critical revision of the article: D.A. Sirota, A.M. Chernyavskiy
Experimental part: M.O. Zhulkov, H.A. Agaeva, A.K. Sabetov, I.S. Zykov, A.R. Tarkova
Final approval of the version to be published: M.O. Zhulkov, K.V. Kozyr, I.S. Zykov, A.R. Tarkova, H.A. Agaeva, A.K. Sabetov, D.A. Sirota, D.S. Sergeevichev, A.M. Chernyavski

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