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Transfemoral transcatheter puncture of interventricular septum in a swine model: A novel transfemoral-venous access to left ventricle with the assistance of arterio-venous circuit

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机构: [1]Chinese Acad Med Sci & Peking Union Med Coll, Cardiovasc Inst, Dept Struct Heart Dis, Beijing, Peoples R China [2]Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Beijing, Peoples R China [3]Chinese Acad Med Sci & Peking Union Med Coll, Cardiovasc Inst, Dept Pathol, Beijing, Peoples R China [4]Beijing TongRen Hosp, Dept Cardiol, Beijing, Peoples R China [5]China Univ Petr, Dept Mat Sci & Engn, Beijing, Peoples R China
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关键词: arterio-venous circuit femoral interventricular septum puncture transcatheter transseptal approach

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Objective Via subclavian/jugular vein, successful puncture of interventricular septum (IVS) has been achieved transvenously. However, the approach was limited by acute entry-angle. The study was conducted to investigate a novel transcatheter puncture of IVS via femoral access and transfemoral-venous access to left ventricle (LV) through IVS. Methods Via femoral artery, transcatheter puncture of mid-IVS was performed with a custom-made nickel-titanium needle and 6F-sheath in 16 healthy mini-swine. Then femoral arterio-venous circuit was established through IVS. After pre-dilation of IVS, a 20F-sheath was introduced into LV transvenously over-the-guidewire in 15 swine. Furthermore, transfemoral-venous TAVR was attempted with the approach in another swine. IVS was evaluated postoperatively and was further confirmed pathologically 2 months later. Results All transcatheter puncture of IVS was performed successfully in LV and the mid-IVS thickness was 7.67 +/- 0.98 mm. In all swine, femoral arterio-venous circuit was established via IVS, and a 20F-sheath was introduced into LV and aorta transfemoral-venously (entry-angle: 145.3 +/- 12.2 degrees in front view). After the procedure, there was one swine with moderate tricuspid-regurgitation and five swine with mild residual-shunt (2.6 +/- 0.7 mm). Two months later, residual-shunt was still detected in three swine and the communication was confirmed pathologically. In other swine, no defect occurred and replacement-scar was identified along puncture-tract. In the swine underwent transfemoral-venous TAVR, prosthetic valve was deployed successfully with good function. Conclusions Transfemoral transcatheter puncture of IVS is feasible and safe in a swine model, and large sheath can be introduced into LV transfemoral-venously using the novel access with the aid of vessel circuit.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 4 区 心脏和心血管系统
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 心脏和心血管系统
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出版当年[2018]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2024]版:
Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

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第一作者机构: [1]Chinese Acad Med Sci & Peking Union Med Coll, Cardiovasc Inst, Dept Struct Heart Dis, Beijing, Peoples R China [2]Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Beijing, Peoples R China [*1]Fuwai Hosp, Dept Struct Heart Dis, 167 Beilishi Rd, Beijing 100037, Peoples R China
通讯作者:
通讯机构: [1]Chinese Acad Med Sci & Peking Union Med Coll, Cardiovasc Inst, Dept Struct Heart Dis, Beijing, Peoples R China [2]Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Beijing, Peoples R China [*1]Fuwai Hosp, Dept Struct Heart Dis, 167 Beilishi Rd, Beijing 100037, Peoples R China
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