Second-generation percutaneous bioprosthetic valve: A short-term study in sheep Dusan Pavcnik, MD, PhD, John Kaufman, MD, Barry Uchida, BS, Luiz Correa,

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Second-generation percutaneous bioprosthetic valve: A short-term study in sheep Dusan Pavcnik, MD, PhD, John Kaufman, MD, Barry Uchida, BS, Luiz Correa, MD, Takao Hiraki, MD, Seong Chang Kyu, MD, Frederick S. Keller, MD, Josef Rosch, MD, Journal of Vascular Surgery Volume 40, Issue 6, Pages 1223-1227 (December 2004) DOI: 10.1016/j.jvs.2004.08.027 Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 1 Second-generation bioprosthetic venous valve. A, Stainless steel Z-stent is attached to apex of original square stent valve. Z-stent has barbs at its upper bends. B, Nonrestrained nitinol double-stent bioprosthetic venous valve with 4 barbs for maximal vein diameter of 12 to 14 mm. Journal of Vascular Surgery 2004 40, 1223-1227DOI: (10.1016/j.jvs.2004.08.027) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 2 Function of double-stent bioprosthetic venous valve placed in sheep jugular vein 11 mm in diameter at 6-week follow-up. A, Jugular venogram with injection above valve demonstrates valve patency. B, High-volume injection of contrast medium below valve does not reveal any reflux, and demonstrates valve closure. Journal of Vascular Surgery 2004 40, 1223-1227DOI: (10.1016/j.jvs.2004.08.027) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 3 Specimen and histologic analysis of 10-mm to 12-mm double-stent bioprosthetic venous valve placed in sheep jugular vein 11 mm in diameter at 6-week follow-up. A, Axial view from above shows incorporation of valve into vein wall. B, Longitudinally cut specimen shows smooth, almost complete incorporation of the double-stent bioprosthetic venous valve into vein wall. C, Longitudinal microscopic view of small intestinal submucosa leaflet (original mgnification ×2). D, Magnified view of early remodeled small intestinal submucosa leaflet reveals endothelial and other host cells, as previously described5,8 (hematoxylin-eosin stain; original magnification ×200). Journal of Vascular Surgery 2004 40, 1223-1227DOI: (10.1016/j.jvs.2004.08.027) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions