Background

Transcatheter aortic valve implants (TAVI) have revolutionised the treatment of elderly patients requiring aortic valve replacement. These patients often do not tolerate balloon valvuloplasty well, and a valvuloplasty balloon that would allow a degree of continued cardiac output during expansion would be beneficial. We tested such a balloon and describe our results in the sheep model.

Methods and Results

We developed a non-occlusive balloon (NOB) catheter. An acute experiment was performed where the NOB was inflated in six sheep in the aortic valve position without any attempt to arrest cardiac output. Two inflations were performed per animal: the first for 30 s and the second for 2–3 min. Standard occlusive balloons were inflated in two animals under rapid ventricular pacing to serve as controls. Mean pressure gradient across the NOB was 9.7 ± 5 mmHg during the inflations and all animals remained hemodynamically stable during NOB inflations.

Conclusions

The novel non-occlusive balloon catheter, which permitted uninterrupted cardiac output for a prolonged period without the need for pacing-induced temporary cessation of cardiac output, is both feasible and well tolerated in the acute sheep model.

中文翻译：

---

使用非阻塞性球囊导管进行球囊主动脉瓣膜成形术：首次动物体验。

背景

经导管主动脉瓣植入物（TAVI）彻底改变了需要更换主动脉瓣的老年患者的治疗方法。这些患者通常不能很好地耐受球囊瓣膜成形术，并且在扩张过程中允许一定程度的持续心输出量的瓣膜成形术球囊将是有益的。我们测试了这种气球，并在绵羊模型中描述了我们的结果。

方法与结果

我们开发了一种非阻塞性球囊（NOB）导管。进行了一项急性实验，其中在主动脉瓣位置的六只绵羊中，NOB被充气，而没有任何试图阻止心输出量的尝试。每只动物两次充气：第一次充气30 s，第二次充气2-3 min。在两只动物的快速心室起搏下，将标准闭塞球囊充气以作为对照。充气期间，整个NOB的平均压力梯度为9.7±5 mmHg，并且所有动物在NOB充气期间均保持血液动力学稳定。

结论

在急性绵羊模型中，新颖的非阻塞性球囊导管允许长期不间断的心输出量，而无需起搏引起的心输出量的暂时停止，既可行又耐受性好。