Biomedical Engineering Reference
In-Depth Information
monofi lament sutures. The valve is mounted on the middle element (com-
missural level) of the frame. The lower conical part of the frame is covered
by pericardium. The design and the mounting on the frame are based on
the goal of reducing local stress and therefore enhancing durability.
Design and mounting also take in consideration the goal of reducing the
overall size and improving the quality of folding when compressed for
implantation. In vitro tests confi rm that the CoreValve frame with mounted
valve can be compressed in a 21 Fr outer-diameter catheter. Histologic
studies to validate the integrity of the tissue valve following compression
and decompression prior to implantation showed no trauma to the valve
(data provided by CoreValve).
5.2.4 The Edwards SAPIEN catheter
Femoral arterial sheaths (Edwards Lifesciences Inc.) have an internal diam-
eter of 22F (8 mm external diameter) to accommodate the 23 mm pros-
thetic valve and 24F (9 mm external diameter) for the 26 mm valve. With
a steerable guiding catheter (Retrofl ex ® , Edwards Lifesciences Inc.) the
balloon-mounted valve is passed through the aorta and positioned within
the predilated aortic native valve. This procedure is achieved retrogradely
(Fig. 5.4).
(a)
￿ ￿ ￿ ￿ ￿
(b)
5.4 Retrograde approach. (a) Introducer/Loader; (b) RetroFlex,
catheter.
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