An Engineering Review of Transcatheter Aortic Valve Technologies

  • Muralidhar Padala
  • Eric L. Sarin
  • Patrick Willis
  • Vasilis Babaliaros
  • Peter Block
  • Robert A. Guyton
  • Vinod H. Thourani
Article

Abstract

Senile aortic stenosis (AS), the narrowing and progressive dysfunction of the valve between the heart and the aorta, is the most common structural heart disease in the elderly, with an estimated increase in prevalence from approximately 38.7 million in 2008 to 88.5 million by 2050. The indications for conventional open aortic valve replacement (AVR) utilizing cardiopulmonary bypass remains the standard of care with excellent results. However, physicians remain reluctant to recommend AVR for elderly patients or those considered very high risk. The advent of transcatheter aortic valve intervention (TAVI, transfemoral, and transapical) represents a tremendous advance in our ability to treat high-risk patients with severe AS. By avoiding the risks associated with aortic cross-clamping and cardiopulmonary bypass, it provides a treatment alternative for patients deemed too high risk for conventional AVR. However, this technology is still in the initial stages of clinical use and thus several design challenges and opportunities for improvements in the engineering concepts exist. This paper reviews the outcomes of the two TAVI technologies currently in wide clinical use, the Edwards Sapien® Valve (ESV) and the Medtronic CoreValve® (MCV) and discusses potential improvements in the current design.

Keywords

Aortic valve Aortic stenosis Transcatheter aortic valve technologies Heart valve hemodynamics 

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Copyright information

© Biomedical Engineering Society 2010

Authors and Affiliations

  • Muralidhar Padala
    • 1
  • Eric L. Sarin
    • 2
  • Patrick Willis
    • 3
  • Vasilis Babaliaros
    • 3
  • Peter Block
    • 3
  • Robert A. Guyton
    • 2
    • 4
  • Vinod H. Thourani
    • 2
    • 4
  1. 1.Wallace H. Coulter Department of Biomedical EngineeringGeorgia Institute of TechnologyAtlantaUSA
  2. 2.Clinical Research Unit, Division of Cardiothoracic SurgeryEmory University School of MedicineAtlantaUSA
  3. 3.Division of CardiologyEmory University of MedicineAtlantaUSA
  4. 4.Division of Cardiac Surgery, Emory University Hospital MidtownAtlantaUSA

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