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A Repositionable Valved Stent for Endovascular Treatment of Deteriorated Bioprostheses

Rachid Zegdi, MD, PhD^_*,,_*, Ziad Khabbaz, MD, Nicolas Borenstein, DVM and Jean-Noël Fabiani, MD^_*,

^_* Université René Descartes, Paris V, France
AP-HP, Service de Chirurgie Cardio-Vasculaire, Hôpital Européen Georges Pompidou, Paris, France
IMM Recherche, Institut Mutualiste Montsouris, Paris, France

View larger version (69K): [in a new window]   Figure 1 Representation of the principle of compression-relaxation of the valved stent. (Top, left) The stent has been compressed by exerting traction on the 2 encircling sutures. (Top, right) The stent has been reversibly deployed. (Bottom) The 2 sutures are proximally connected to a handle.

View larger version (47K): [in a new window]   Figure 2 Echocardiographic color Doppler study before and after endovascular valve replacement of a failed bioprosthesis. (Left) Tricuspid regurgitant jet extending into the inferior vena cava (IVC). (Right) Absence of any tricuspid regurgitation after valved stent delivery. RA = right atrium.

View larger version (117K): [in a new window]   Figure 3 Representation of valved stent repositioning. (Top, left) The valved stent has been voluntarily misplaced too proximally inside the failed bioprosthesis. (Top, right) Recompression of the valved stent. (Bottom, left) The valved stent has been ultimately delivered in an adequate position. (Bottom, right) Right lateral view of the heart (the right atrium and the anterior part of the right ventricle have been resected) showing excellent positioning of the valved stented inside the failed bioprosthesis.