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Transcatheter aortic valve implantation


Falk, Volkmar; Walther, Thomas (2012). Transcatheter aortic valve implantation. In: Inderbitzi, Rolf Gilbert Carl; Schmid, Ralph Alexander; Melfi, Franca M A; Casula, Roberto Pasquale. Minimally Invasive Thoracic and Cardiac Surgery. Berlin Heidelberg: Springer, 465-484.

Abstract

Transcatheter aortic valve implantation was first described by Cribier in 2002 [1] and since then has evolved as a routine procedure for high-risk patients with aortic stenosis [2, 3]. As by June 2010, 10,000 transfemoral (TF) implants of the CoreValve™ prosthesis (Medtronic Inc., Minneapolis, MN, USA) and approximately a similar number of TF and transapical (TA) implants of the Edwards Sapien™ prosthesis (Edwards Lifesciences Inc., Irvine, CA, USA) have been reported. While most centers report encouraging procedural results, mid- and long-term data are sparse. No randomized trials have been conducted to prove similar or better outcomes with transfemoral (TF) or transapical (TA) aortic valve implantation (AVI) compared to conventional aortic valve replacement (AVR). Appropriate indications, patient selection and risk assessment, the ideal setting to perform TF/TA-AVI, the involved imaging techniques, and periprocedural treatment are currently under investigation. A high incidence of paravalvular leaks and AV-block, challenges in device positioning, and procedure-related and previously unknown complications have stimulated new design concepts for transcatheter valves that are currently undergoing clinical trials.

Abstract

Transcatheter aortic valve implantation was first described by Cribier in 2002 [1] and since then has evolved as a routine procedure for high-risk patients with aortic stenosis [2, 3]. As by June 2010, 10,000 transfemoral (TF) implants of the CoreValve™ prosthesis (Medtronic Inc., Minneapolis, MN, USA) and approximately a similar number of TF and transapical (TA) implants of the Edwards Sapien™ prosthesis (Edwards Lifesciences Inc., Irvine, CA, USA) have been reported. While most centers report encouraging procedural results, mid- and long-term data are sparse. No randomized trials have been conducted to prove similar or better outcomes with transfemoral (TF) or transapical (TA) aortic valve implantation (AVI) compared to conventional aortic valve replacement (AVR). Appropriate indications, patient selection and risk assessment, the ideal setting to perform TF/TA-AVI, the involved imaging techniques, and periprocedural treatment are currently under investigation. A high incidence of paravalvular leaks and AV-block, challenges in device positioning, and procedure-related and previously unknown complications have stimulated new design concepts for transcatheter valves that are currently undergoing clinical trials.

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Additional indexing

Item Type:Book Section, not refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:15 Feb 2013 10:16
Last Modified:07 Dec 2017 19:14
Publisher:Springer
ISBN:978-3-642-11861-6
Publisher DOI:https://doi.org/10.1007/978-3-642-11861-6_43

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