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Percutaneous implantation of a biological valve in the pulmonary position has recently enlarged the field of interventional cardiovascular catheterisation.1 Aortic valve disease is much more frequent than pulmonary valve disease and therefore a non-surgical approach for aortic valve replacement would be attractive. The percutaneous approach is obviously difficult because of the proximity of the aortic valve to the coronary orifices. We set out to develop a stent for valve implantation which avoids obstructing the coronary orifices. We describe here our initial experience using the new device for percutaneous valve replacement of the aortic valve in an animal study.
A newly designed stent with a deployment strategy in two steps was developed. The first step assures the orientation of the stent in the aortic orifice. The second acts as a support for the implantable valve. A naturally valved bovine jugular vein segment was mounted as previously described inside this stent (Numed, Osypka).2The venous wall was then reduced along the commissures in order to remove the wall in front of the coronary orifices (fig 1).