Advertisement

New Approaches for Aortic Valve Disease: From Transcatheter Aortic Valve Implantation to Sutureless Aortic Valves

  • Giuseppe Santarpino
  • Renato Gregorini
  • Theodor Fischlein
Chapter

Abstract

Transcatheter aortic valve implantation (TAVI) has been shown to effectively expand the therapeutic possibilities in patients with aortic valve disease unfit for aortic valve replacement. However especially the costs and the risk of paravalvular leakage have been recognized as important limitations of these approach. Sutureless aortic valve bioprostheses have been developed to facilitate aortic valve replacement and reduce the duration of aortic cross-clamping and its related adverse events. We have recently compared the results with sutureless Perceval aortic valve bioprostheses versus the transcatheter aortic valve implantation. In this chapter we review the published results of a single center of the TAVI and surgical aortic valve replacement with this sutureless valve bioprostheses.

Keywords

Minimally invasive surgery Aortic valve disease Heart valve prosthesis Biological devices Frailty 

References

  1. 1.
    Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Baron-Esquivias G, Baumgartner H, et al. Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg. 2012;42:S1–44.CrossRefGoogle Scholar
  2. 2.
    Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, Brown DL, Block PC, Guyton RA, Pichard AD, Bavaria JE, Herrmann HC, Douglas PS, Petersen JL, Akin JJ, Anderson WN, Wang D, Pocock S, PARTNER Trial Investigators. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597e1607.CrossRefGoogle Scholar
  3. 3.
    Popma JJ, Adams DH, Reardon MJ, Yakubov SJ, Kleiman NS, Heimansohn D, Hermiller J Jr, Hughes GC, Harrison JK, Coselli J, Diez J, Kafi A, Schreiber T, Gleason TG, Conte J, Buchbinder M, Deeb GM, Carabello B, Serruys PW, Chenoweth S, Oh JK, CoreValve United States Clinical Investigators. Transcatheter aortic valve replacement using a self-expanding bioprosthesis in patients with severe aortic stenosis at extreme risk for surgery. J Am Coll Cardiol. 2014;63:1972e1981.CrossRefGoogle Scholar
  4. 4.
    Reynolds MR, Magnuson EA, Wang K, Thourani VH, Williams M, Zajarias A, Rihal CS, Brown DL, Smith CR, Leon MB, Cohen DJ, PARTNER Trial Investigators. Health-related quality of life after transcatheter or surgical aortic valve replacement in high-risk patients with severe aortic stenosis: results from the PARTNER (Placement of AoRTic TraNscathetER Valve) Trial (Cohort A). J Am Coll Cardiol. 2012;60:548–58.CrossRefGoogle Scholar
  5. 5.
    Strauch JT, Scherner M, Haldenwang PL, Madershahian N, Pfister R, Kuhn EW, Liakopoulos OJ, Wippermann J, Wahlers T. Transapical minimally invasive aortic valve implantation and conventional aortic valve replacement in octogenarians. Thorac Cardiovasc Surg. 2012;60:335e342.Google Scholar
  6. 6.
    Beckmann A, Funkat AK, Lewandowski J, et al. Cardiac surgery in Germany during 2014: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery. Thorac Cardiovasc Surg. 2015;63:258–69.CrossRefGoogle Scholar
  7. 7.
    Johnston DR, Atik FA, Rajeswaran J, Blackstone EH, Nowicki ER, Sabik JF III, et al. Outcomes of less invasive J-incision approach to aortic valve surgery. J Thorac Cardiovasc Surg. 2012;144:852–8.e3.CrossRefGoogle Scholar
  8. 8.
    Martens S, Sadowski J, Eckstein FS, Bartus K, Kapelak B, Sievers HH, et al. Clinical experience with the ATS 3f Enable Sutureless Bioprosthesis. Eur J Cardiothorac Surg. 2011;40:749–55.PubMedGoogle Scholar
  9. 9.
    Kocher AA, Laufer G, Haverich A, Shrestha M, Walther T, Misfeld M, et al. One-year outcomes of the Surgical Treatment of Aortic Stenosis With a Next Generation Surgical Aortic Valve (TRITON) trial: a prospective multicenter study of rapid-deployment aortic valve replacement with the EDWARDS INTUITY Valve System. J Thorac Cardiovasc Surg. 2013;145:110–5.. discussion 115-6CrossRefGoogle Scholar
  10. 10.
    Folliguet TA, Laborde F, Zannis K, Ghorayeb G, Haverich A, Shrestha M. Sutureless Perceval aortic valve replacement: results of two European centers. Ann Thorac Surg. 2012;93:1483–8.CrossRefGoogle Scholar
  11. 11.
    Santarpino G, Pfeiffer S, Schmidt J, Concistre G, Fischlein T. Sutureless aortic valve replacement: first-year single-center experience. Ann Thorac Surg. 2012;94:504–8.. discussion 508-9CrossRefGoogle Scholar
  12. 12.
    Santarpino G, Pfeiffer S, Concistré G, Grossmann I, Hinzmann M, Fischlein T. The Perceval S aortic valve has the potential of shortening surgical time: does it also result in improved outcome? Ann Thorac Surg. 2013;96:77e81.CrossRefGoogle Scholar
  13. 13.
    Santarpino G, Pfeiffer S, Vogt F, Hinzmann M, Concistrè G, Fischlein T. Advanced age per se should not be an exclusion criterion for minimally invasive aortic valve replacement. J Heart Valve Dis. 2013;22:455e459.Google Scholar
  14. 14.
    Santarpino G, Pfeiffer S, Jessl J, Dell'Aquila AM, Pollari F, Pauschinger M, Fischlein T. Sutureless replacement versus transcatheter valve implantation in aortic valve stenosis: a propensity-matched analysis of 2 strategies in high-risk patients. J Thorac Cardiovasc Surg. 2014;147(2):561–7.CrossRefGoogle Scholar
  15. 15.
    Santarpino G, Pfeiffer S, Jessl J, Dell'Aquila A, Vogt F, von Wardenburg C, Schwab J, Sirch J, Pauschinger M, Fischlein T. Clinical outcome and cost analysis of sutureless versus transcatheter aortic valve implantation with propensity score matching analysis. Am J Cardiol. 2015;116(11):1737–43.CrossRefGoogle Scholar
  16. 16.
    Biancari F, Rosato S, D’Errigo P, et al. Immediate and intermediate outcome after transapical versus transfemoral transcatheter aortic valve replacement. Am J Cardiol. 2016;117:245–51.CrossRefGoogle Scholar
  17. 17.
    Blackstone EH, Suri RM, Rajeswaran J, et al. Propensity-matched comparisons of clinical outcomes after transapical or transfemoral transcatheter aortic valve replacement: a placement of aortic transcatheter valves (PARTNER)-I trial substudy. Circulation. 2015;131:1989–2000.CrossRefGoogle Scholar
  18. 18.
    Santarpino G, Vogt F, Pfeiffer S, Dell’Aquila AM, Jessl J, Cuomo F, von Wardenburg C, Fischlein T, Pauschinger M, Schwab J. Sutureless vs transfemoral transcatheter aortic valve implant: a propensity score matching study. J Heart Valve Dis. 2017;26:255–61.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Giuseppe Santarpino
    • 1
    • 2
  • Renato Gregorini
    • 1
  • Theodor Fischlein
    • 2
  1. 1.Città di Lecce Hospital, GVM Care & ResearchLecceItaly
  2. 2.Klinikum Nürnberg, Paracelsus Medical University NurembergNurembergGermany

Personalised recommendations