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Transcatheter Aortic Valve Implantation: Review of Current Evidence

Chapter

Abstract

Symptomatic severe aortic stenosis (AS) has a poor prognosis when treated medically and inevitably leads to an insidious functional deterioration, heart failure, and death [1]. Surgical aortic valve replacement (SAVR) is the current standard of care and is an accepted method to alleviate symptoms and prolong survival. For an array of reasons, approximately 30 % do not undergo SAVR [2]. However, since Dr. Alain Cribier pioneered the first transcatheter aortic valve replacement (TAVR) procedure in 2002 [3], this relatively new technique has been used extensively in over 40 countries accumulating to >50,000 implantations [4–19]. With results from the randomized PARTNER trial [20], TAVR has emerged as the standard of care for extremely high-risk or “inoperable” patients and is a valid alternative to surgery for selected high-risk but “operable” patients with symptomatic AS [21]. Currently, two different TAVR devices are widely available and used: the balloon-expandable Edwards SAPIEN Transcatheter Heart Valve (Edwards Lifesciences, Irvine, CA) and the self-expanding Medtronic CoreValve™ (Medtronic, Minneapolis, MN). Both devices received CE Mark approval for European commercial sale in 2007, and the Edwards SAPIEN valve received FDA pre-market approval in the USA in November 2011.

Keywords

Technology innovation Registries Clinical outcomes TAVR Paravalvular regurgitation 

Abbreviations

AS

Aortic stenosis

EuroSCORE

European System for Cardiac Operative Risk Evaluation

I-REVIVE

Initial Registry of Endovascular Implantation of Valves in Europe trial

PARTNER

Placement of Aortic Transcatheter Valves

RECAST

Registry of Endovascular Critical Aortic Stenosis Treatment trial

REVIVAL

Percutaneous Endovascular Implantation of Valves trial

REVIVE

Registry of Endovascular Implantation of Valves in Europe trial

SAVR

Surgical aortic valve replacement

SOURCE

SAPIEN Aortic Bioprosthesis European Outcome

STS

Society of Thoracic Surgeons

TA

Transapical

TAVR

Transcatheter aortic valve implantation

TF

Transfemoral

TRAVERCE

The initial multicenter feasibility trial for TA-AVI

VARC

Valve Academic Research Consortium

Notes

Conflicts of Interest

Philippe Généreux has received consulting fees/honoraria from Edwards Lifesciences. Martin B. Leon is a nonpaid member of the Scientific Advisory Boards of Edwards Lifesciences and Medtronic Vascular.

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Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of Cardiology, Cardiovascular Research FoundationColumbia University Medical CenterNew YorkUSA
  2. 2.Departement de Cardiologie D’Intervention, Hôpital du Sacré-Coeur de MontréalUniversité de MontréalMontréalCanada
  3. 3.Department of MedicineColumbia University Medical Center, New York-Presbyterian HospitalNew YorkUSA

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