scholarly journals A Glimpse into the Future: In 2020, Which Patients will Undergo TAVI or SAVR?

2017 ◽  
Vol 12 (01) ◽  
pp. 44 ◽  
Author(s):  
Crochan J O’sullivan ◽  
Peter Wenaweser ◽  
◽  
◽  
Keyword(s):  
Aortic Valve ◽  
Heart Valves ◽  
Severe Aortic Stenosis ◽  
Vascular Complications ◽  
Surgical Aortic Valve Replacement ◽  
Operator Experience ◽  
First Line Therapy ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Valve Implantation

Transcatheter aortic valve implantation (TAVI) has evolved into a safe and effective procedure to treat symptomatic patients with severe aortic stenosis (AS), with predictable and reproducible results. Rates of important complications such as vascular complications, strokes and paravalvular leaks are lower than ever, because of improved patient selection, systematic use of multidector computer tomography, increasing operator experience and device iteration. Accumulating data suggest that transfemoral TAVI with newer generation transcatheter heart valves and delivery systems is superior to conventional surgical aortic valve replacement among intermediate- and high-risk patients with severe symptomatic AS with regard to all-cause mortality and stroke. One can anticipate that by 2020, the majority of patients with severe symptomatic AS will undergo TAVI as first line therapy, regardless of surgical risk.

scholarly journals How to reduce uncommon but severe transcatheter aortic valve implantation complications: stroke, thrombosis, endocarditis, cognitive decline?

2021 ◽  
Vol 23 (Supplement_E) ◽  
pp. E142-E146
Author(s):  
Francesco Saia ◽  
Mateusz Orzalkiewicz
Keyword(s):  
Aortic Valve ◽  
Cognitive Decline ◽  
Transcatheter Aortic Valve Implantation ◽  
Heart Valves ◽  
Severe Aortic Stenosis ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Valve Thrombosis ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Transcatheter aortic valve implantation has become a valid alternative to surgical aortic valve replacement for patients with symptomatic severe aortic stenosis, regardless of baseline surgical risk. The incidence of periprocedural complications has steadily declined over the years, thanks to technical advancement of transcatheter heart valves, delivery systems, and increased operators’ experience. Beyond the most common periprocedural complications, there are a few uncommon but potentially severe complications that more often occur during follow-up, although they may also arise in the periprocedural phase. Stroke, infective endocarditis, valve thrombosis, and cognitive decline are among them. In this brief review, we describe the incidence, predictive factors, and potential preventive measures for those events.

scholarly journals Transcatheter Aortic Valve Implantation in Small Anatomy: Patient Selection and Technical Challenges

2018 ◽  
Vol 13 (2) ◽  
pp. 1 ◽  
Author(s):  
Makoto Nakashima ◽  
Yusuke Watanabe ◽  
◽  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Patient Selection ◽  
Severe Aortic Stenosis ◽  
Vascular Complications ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Low Incidence ◽  
Valve Implantation

Transcatheter aortic valve implantation (TAVI) has become a standard treatment for severe aortic stenosis. Although this technique has reached relative maturity, further optimisation of patient selection and device implantation is essential to improve prognosis. Smaller body size is a predictor of a challenging TAVI procedure due to specific anatomical difficulty and adverse events including annulus rupture, acute coronary obstruction and vascular complications. A newer generation, lower profile TAVI system is useful for patients with smaller anatomy. Moreover, TAVI is superior to surgical aortic valve replacement in patients with a narrowing annulus because this treatement has a low incidence of prosthesis�patient mismatch.

ACURATE neo™ Aortic Valve System for the treatment of aortic stenosis

2021 ◽  
Author(s):  
Jan-Erik Guelker ◽  
Won-Keun Kim ◽  
Johannes Blumenstein ◽  
Helge Möllmann ◽  
Oliver Husser
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Heart Valves ◽  
Severe Aortic Stenosis ◽  
Standard Of Care ◽  
Next Generation ◽  
Operator Experience ◽  
Advantages And Disadvantages ◽  
Transcatheter Aortic Valve ◽  
Risk Patients

Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of patients with severe aortic stenosis and is now standard of care for high surgical risk patients and a valid alternative strategy in intermediate risk patients. Recently, TAVR has shown excellent results in low-risk patients, indicating an imminent extension toward this population. Improvements in procedural outcomes are the result of increasing operator experience, sophisticated imaging for procedural planning but also due to the continuous evolution of transcatheter heart valves developed to minimize procedural complications. ‘Next-generation’ valves are currently available, among them the self-expanding ACURATE neo. Here, the technical details and clinical outcomes of the ACURATE neo are reviewed, comparative data with other ‘next-generation’ valves and potential advantages and disadvantages are discussed.

Management and Prevention of Vascular Complications Related to Transcatheter Aortic Valve Implantation and Aortic Aneurysm Repair Procedures – A Technical Note

2010 ◽  
Vol 5 (1) ◽  
pp. 81
Author(s):  
Andrea Pacchioni ◽  
Dimitris Nikas ◽  
Carlo Penzo ◽  
Salvatore Saccà ◽  
Luca Favero ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Transcatheter Aortic Valve Implantation ◽  
Severe Aortic Stenosis ◽  
Vascular Complications ◽  
Technical Note ◽  
Closure Device ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Transcatheter aortic valve implantation (TAVI) and endovascular aortic repair (EVAR) are increasingly being used as therapeutic options for patients with severe aortic stenosis who are ineligible for surgery and who have aortic aneurysm with suitable anatomical features. These procedures can be associated with severe complications, especially related to vascular access and the use of a large introducer sheath (from 18 to 24 French [Fr]). In this article we describe possible vascular complications emerging during TAVI and EVAR and their appropriate management, beginning with patient selection, the correct way to perform vessel puncture and the use of a vascular closure device, up to the recently proposed cross-over technique, which is thought to minimise the risk of dangerous consequences of vascular damage.

A valve-in-valve transcatheter aortic valve implantation with commissural alignment using advanced imaging reconstruction: a case report

2020 ◽  
Vol 3 (10) ◽  
pp. 01-05
Author(s):  
Marco Angelillis
Keyword(s):  
Aortic Valve ◽  
Severe Aortic Stenosis ◽  
Coronary Intervention ◽  
Easy Access ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Structural Valve Deterioration ◽  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation

Transcatheter valve in valve (ViV) implantation actually represents a valid alternative to surgical reinterventions in patients with previous surgical aortic valve replacement (AVR). In patients less than 80 years old, it is crucial to correctly position the new valve leaving a feasible and easy access to coronary ostia, both for future percutaneous coronary intervention (PCI) than for a future possible TAVinTAV procedure. We report a 71 year old man with prior AVR presented with structural valve deterioration (SVD) leading to severe aortic stenosis. In order to guarantee comfortable coronary access we aligned, the commissures of the new percutaneous valve with the ones of the surgical bioprothesis by reconstructing the headframes of the surgical bioprosthesis with computer tomography (CT) and fluoro-CT.

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