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Hybrid Balloon Valvuloplasty for the Treatment of Severe Congenital Aortic Valve Stenosis in Infants Wen-Bin Ou-Yang, MD, Shou-Jun Li, MM, Yong-Quan Xie, MD, Sheng-Shou Hu, MD, Shou-Zheng Wang, MD, Feng-Wen Zhang, MM, Gai-Li Guo, MM, Yao Liu, MD, Kun-Jing Pang, MM, Xiang-Bin Pan, MD The Annals of Thoracic Surgery Volume 105, Issue 1, Pages (January 2018) DOI: /j.athoracsur Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions
Fig 1 Appearance of (A) percutaneous and (B) new arterial sheath. The new sheath has a 120-degree-angle elbow in the head end, 2 holders, an adapter, a dilator, and a vent for exhaust. (C) In animal experiments, the percutaneous arterial sheath is almost perpendicular to the ascending aorta (black arrow), which will lead the guidewire to the aortic wall and the wire, then turning to the direction of aortic valve. (D) In contrast to the case with the percutaneous sheath, the elbow of the new sheath allows the operator to directly and quickly lead the guidewire to the aortic valve orifice (black arrow), thereby reducing operation time and damage to the aortic wall. The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions
Fig 2 Main process of hybrid balloon valvuloplasty performed under transesophageal echocardiography guidance in an ordinary operating room with the new sheath. (A) Aortic valve annulus diameter and valve anatomy were evaluated by echocardiography. (B) Peak aortic valve gradient was measured by Doppler preoperatively. (C) The guidewire (arrow) was inserted into left ventricle (LV) under echocardiography guidance. (D) The balloon catheter (arrow) was held by hand, and a pacemaker was used at a rate of 180 impulses/min during dilation. (E) The balloon (arrow) was dilated over the aortic valve. (F) The peak aortic valve gradient was measured by Doppler after dilation. (AA = ascending aorta; LA = left atrium; RV = right ventricle.) The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions
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