Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Endovascular formation of aorto-pulmonary anastomosesin the conditions of the experiment

Authors: Т.М. Dzhincharadze, N.A. Chigogidze

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2018-15-1-54-64

UDC: 616.131-007.2-089.863:611.08

Link: Clinical Physiology of Blood Circulaiton. 2018; 15 (1): 54-64

Quote as: Dzhincharadze T.M., Chigogidze N.A. Endovascular formation of aorto-pulmonary anastomoses in the conditions of the experiment. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2018; 15 (1): 54–64 (in Russ.). DOI: 10.24022/1814-6910-2018-15-1-54-64

Received / Accepted:  11.01.2018/07.02.2018

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Abstract

Objective. The experimental development of the technology of endovascular creation of aorto-pulmonary anastomoses under experimental conditions.

Material and methods. In Bakoulev National Medical Research Center for Cardiovascular Surgery 14 experiments on endovascular formation of interstate aorto-pulmonary anastomoses on dogs weighing from 3.5 to 12 kg were performed. For the optimal choice of the point of interstitial anastomosis creation under experimental conditions, we developed and used the following instruments: magnetic-navigational catheters, kinematic needle for creating the axis between the shunting vessels, the coiled stent prosthesis and the coronary stentgraph of JOSTENT (Abbot & Vascular).

Results. Using the original instrumentation, 7 successful experiments were performed to create an interstitial anastomosis "descending aorta – left branch of the pulmonary artery", 3 experiments on interstitial anastomosis "ascending aorta – right branch of the pulmonary artery" and 4 experiments on anastomosis "ascending aorta – pulmonary trunk arteries". In two experiments in which interstitial anastomoses were created with the help of the coronary stent-graft JOSTENT, complications in the form of bleeding were caused, in the first case, by discrepancy between the length of the stent-graft and the distance between the shunting vessels, in the second case, migration of the coronary stent-graft in the aortic lumen, which is due to constructivities features such as, a small area of adhesion to the walls of the vessel and the lack of adapted fixing edges. In yet another experiment, the error in spatial orientation resulted in lung damage, and was aggravated by the damaging effect of the dislocated stent graft, which led to bleeding from the space between the aorta and the LA.

Conclusion. The use of the developed original instrumentation (kinematic needle, magnetic-navigational catheters, coillike stent-graft) allows the creation of interstitial aorto-pulmonary anastomosis. Evaluation of anatomical semiotics and the correct choice of an implantable device (stent-graft), along with the use of original instruments, increase the effectiveness of endovascular intervention and provide a high level of safety in the conditions of an animal experiment.

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About Authors

  • Dzhincharadze Tengiz Milorovich, Endovascular Surgeon; orcid.org/0000-0003-3965-7619
  • Chigogidze Nikolay Avtandilovich, Cand. Med. Sc., Chief of Department of X-ray Surgical, Electrophysiological Methods of Research and Treatment and Approbation of the Latest Technologies

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