A Translational 'Humanised' Porcine Model for Trans-Septal Mitral Valve Interventions: the Right Pulmonary Vein Approach.

There is an important need to develop a transcatheter/trans-septal-like model which will allow deliverability of mitral valve devices at the right angulation and height above the mitral annulus similar to the human patient. A ministernotomy allowing for TEE probe to be introduced transpericardially was performed in seven animals. In three, a standard trans-septal approach was used to attempt to deliver a device to the level of the mitral plane with a human delivery system. In four cases, a Dacron tube was connected to the RPV and the device introduced to the LA. Under TEE equivalent imaging, the device was then successfully steered to the mitral plane in all cases, having failed in all trans-septal attempts. A combination of transpericardial echocardiographic imaging (TPE) and RPV approach to the LA facilitated successful human-like mitral valve device implantation.