Transcatheter aortic valve implantation: animal experiment and imaging analysis

Objective: To develop a new surgical procedure of minimally-invasive transcatheter aortic valve implantation and to discuss the optimal projecting position for the angiography of aortic sinus. Methods: Ten healthy hybrid dogs were enrolled in this study. Catheter delivery system of 12 F, 14 F and 16 F was inserted through the femoral artery, left iliac artery and infrarenal aorta respectively. The baseline diameters of the above vessels were measured. Left ventriculography using a pigtail catheter via the right carotid was performed, and the best projecting position for demonstrating the aortic sinus was studied. Results: The diameter of the femoral artery, the left iliac artery and the infrarenal aorta was (3.14±0.39) mm, (3.65± 0.45) mm and (5.07±0.63) mm respectively. The 16 F catheter delivery system could be easily inserted through the infrerenal aorta. The ostia of left and right coronary artery and the aortic sinus were well demonstrated in the position of left anterior oblique 32 degree + 5 degree plus cranial 10 degree ± 3 degree. Conclusion:Aortic valve stent can be implanted with transluminal catheter technique via the infrarenal aorta. During angiography the optimal projecting position to visualize the aortic sinus and coronary ostia is left anterior oblique 32 degree±5 degree plus cranial 10 degree ± 3 degree. (authors)