Study on the safety improvement of transthoracic aortic balloon valvuloplasty

Abstract

Objective To explore the security of using a new artery sheath in the transthoracic aortic balloon valvuloplasty. Methods Healthy male piglets began to take food orally, which was rich in cholesterin(0.5%) and in Vitamin D2(100 000 IU daily). Sixteen of them were selected based on the aortic pressure gradient(>30 mmHg, 1 mmHg=0.133 kPa) through transthoracic echocardiography and were randomly divided into 2 groups with 8 cases in each group.The piglets in group A adopted new artery sheath during operations, while the piglets in group B did the old one.Both groups underwent transthoracic aortic balloon valvuloplasty through the ascending aorta via sternotomy. Results The transthoracic aortic ballon valvuloplasty were carried out on all piglets successfully.There were no significant differences in the aortic valve pressure gradient before operation between group A and group B [(41.3±3.9) mmHg vs (40.6±3.5) mmHg, t=0.30, P=0.74]. The aortic valve pressure gradient decreased distinctly to(12.5±1.6) mmHg and(12.8±1.9) mmHg, respectively after operation, and the differences were significant in statistics(t=23.83, 23.79, all P<0.001). And the passage duration of the guide wire through aortic valve was significantly shorter in group A than that in group B [(16.4±2.6) min vs (27.4±4.6) min, t=5.88, P<0.001]. The frequencies(1 to 10) of the guide wire strayed into coronary artery and the cases(0 to 5) of the aortic valve and ascending aorta injured by the guide wire in group A were significantly lower than those in group B, which had statistical significance(Z=-2.183, -2.219, P=0.029, 0.027). Conclusions Transthoracic aortic balloon valvuloplasty is an effective treatment for aortic stenosis.It's much safer to apply the new artery sheath than the old one in the operation. Key words: Aortic stenosis; Aortic balloon valvuloplasty; New artery sheath