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Transcatheter Aortic Valve Implantation (TAVI)

  • Anitha VargheseEmail author
  • Neal Uren
  • Peter F. Ludman
Chapter

Abstract

Transcatheter aortic valve implantation (TAVI) has evolved from novel technology to mainstream therapy in only a few years (Fig. 1.1). The first randomized trial was published in 2010 and 5 years on TAVI is available in more than 65 countries around the world, more than 200,000 valves have been implanted, and estimated global growth is projected to quadruple over the next 10 years. Valve sizing and positioning are crucial and require integration of information regarding type of valve being implanted, route of implantation, underlying anatomy of aortic valve and coronary artery origins, operator experience, and cardiac imaging techniques (Figs. 1.2 and 1.3). Procedures can be performed under a general anaesthetic with guidance from transoesophageal echocardiography (TOE) and 95 % of patients are extubated in the catheter laboratory. Transfemoral TAVI can also be performed using conscious sedation and local anaesthetic without TOE and in some countries this is the preferred technique. We present a case of TAVI performed in the United Kingdom (UK) in 2012 under general anaesthetic (available to view at www.mici.education).

Keywords

Right Coronary Artery Transcatheter Aortic Valve Implantation Aortic Valve Area Paravalvular Leak Severe Tricuspid Regurgitation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 1.1

Transthoracic echocardiogram (aortic short-axis view) showing severe calcific aortic stenosis in a trileaflet valve (AVI 1042 kb)

Video 1.2

Transoesophageal echocardiography demonstrating normal functioning of her bi-leaflet mechanical mitral valve replacement. (AVI 956 kb)

Video 1.3a

Biplane coronary angiography of the right coronary artery (a) in right anterior oblique projection (AVI 3354 kb)

Video 1.3b

Biplane coronary angiography of the right coronary artery (b) in left anterior oblique projection. (AVI 3010 kb)

Video 1.4a

Computed tomography multiplane reformat of iliofemoral system (aleft) (AVI 62859 kb)

Video 1.4b

Computed tomography multiplane reformat of iliofemoral system (bright) (AVI 75388 kb)

Video 1.5

Three dimensional TOE images of aortic valve seen from the aortic side (AVI 507 kb)

Video 1.6

Short axis TOE view of Edwards Sapien aortic valve prosthesis in-situ, showing no aortic regurgitation (AVI 262 kb)

Video 1.7

Surveillance transthoracic echocardiogram showing a normally functioning TAVI prosthesis with minimal paravalvular leak. (AVI 896 kb)

Recommended Reading

  1. 1.
    Nishimura RA, Otto CM, Bonow RO et al. 2014 AHA/ACC Guideline for the management of patients with valvular heart disease. Circulation. 2014;129:e521–e623.Google Scholar
  2. 2.
    Adams DH, Popma JJ, Reardon MJ et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis-CoreValve US Pivotal high-risk study. N Engl J Med. 2014;370:1790–8.Google Scholar
  3. 3.
    Leon M, Smith CR, Mack MJ et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients - PARTNER 2. N Engl J Med. 2016;374:1609–20.Google Scholar
  4. 4.
    Leon MB, Smith CR, Mack M et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery - PARTNER Trial. N Engl J Med. 2010;363:1597–607.Google Scholar

Copyright information

© Springer-Verlag London 2017

Authors and Affiliations

  1. 1.LondonUK
  2. 2.Royal Infirmary of EdinburghEdinburghUK
  3. 3.Queen Elizabeth HospitalBirminghamUK

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