Advertisement

Transcatheter Aortic Valve Therapy

  • Anita Asgar
  • Raoul Bonan
Chapter

Abstract

In ten short years, transcatheter aortic valve implantation has moved from first-in-man to completion of randomized controlled trials. This technology now enables the treatment of patients once felt to be inoperable and has been demonstrated to be an alternative for those at high surgical risk. Despite the advances made, much remains to be learned in regard to patient selection to optimize benefit, optimal device, and annular sizing and the long-term clinical outcomes. For the interventional cardiologist and surgeon, this therapy offers an opportunity to collaborate through systematic evaluation, procedure planning, and execution, to ensure optimal patient outcomes.

Keywords

Aortic Valve Aortic Stenosis Transcatheter Aortic Valve Implantation Valve Leaflet Aortic Annulus 
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.

References

  1. 1.
    Piazza N, et al. Early and persistent intraventricular conduction abnormalities and requirements for pacemaking after percutaneous replacement of the aortic valve. JACC Cardiovasc Interv. 2008;1(3):310–16.PubMedCrossRefGoogle Scholar
  2. 2.
    Tops LF, Wood DA, Delgado V, Schuijf JD, Mayo JR, Pasupati S, et al. Noninvasive evaluation of the aortic root with multislice computed tomography implications for transcatheter aortic valve replacement. JACC Cardiovasc Imaging. 2008;1(3):321–30. doi: 10.1016/j.jcmg.2007.12.006.PubMedCrossRefGoogle Scholar
  3. 3.
    Fraccaro C, et al. Incidence, predictors, and outcome of conduction disorders after transcatheter self-expandable aortic valve implantation. Am J Cardiol. 2011;107(5):747–54.PubMedCrossRefGoogle Scholar
  4. 4.
    Latsios G, et al. “Device landing zone” calcification, assessed by MSCT, as a predictive factor for pacemaker implantation after TAVI. Catheter Cardiovasc Interv. 2010;76(3):431–9.PubMedCrossRefGoogle Scholar
  5. 5.
    FDA press release, November 2011Google Scholar
  6. 6.
    Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187–98. doi: 10.1056/NEJMoa1103510.PubMedCrossRefGoogle Scholar
  7. 7.
    Afilalo J, Eisenberg MJ, Morin JF, Bergman H, Monette J, Noiseux N, et al. Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery. J Am Coll Cardiol. 2010;56(20):1668–76. doi:10.1016/j.jacc.2010.06.039.PubMedCrossRefGoogle Scholar
  8. 8.
    Green P, Woglom AE, Genereux P, Maurer MS, Kirtane AJ, Hawkey M, et al. Gait speed and dependence in activities of daily living in older adults with severe aortic stenosis. Clin Cardiol. 2012. doi: 10.1002/clc.21974.PubMedGoogle Scholar
  9. 9.
    Dewey TM, Brown DL, Herbert MA, Culica D, Smith CR, Leon MB, et al. Effect of concomitant coronary artery disease on procedural and late outcomes of transcatheter aortic valve implantation. Ann Thorac Surg. 2010;89(3):758–67. doi: 10.1016/j.athoracsur.2009.12.033. discussion 767.PubMedCrossRefGoogle Scholar
  10. 10.
    Buzzatti N, Maisano F, Latib A, Cioni M, Taramasso M, Mussardo M, et al. Computed tomography-based evaluation of aortic annulus, prosthesis size and impact on early residual aortic regurgitation after transcatheter aortic valve implantation. Eur J Cardiothorac Surg. 2012. doi: 10.1093/ejcts/ezs155.Google Scholar
  11. 11.
    Kempfert J, Van Linden A, Lehmkuhl L, Rastan AJ, Holzhey D, Blumenstein J, et al. Aortic annulus sizing: echocardiographic vs. computed tomography derived measurements in comparison with direct surgical sizing. Eur J Cardiothorac Surg. 2012. doi: 10.1093/ejcts/ezs064.Google Scholar
  12. 12.
    Leipsic J, Gurvitch R, Labounty TM, Min JK, Wood D, Johnson M, et al. Multidetector computed tomography in transcatheter aortic valve implantation. JACC Cardiovasc Imaging. 2011;4(4):416–29. doi: 10.1016/j.jcmg.2011.01.014.PubMedCrossRefGoogle Scholar
  13. 13.
    Leon MB, Kodali S, Williams M, Oz M, Smith C, Stewart A, et al. Transcatheter aortic valve replacement in patients with critical aortic stenosis: rationale, device descriptions, early clinical experiences, and perspectives. Semin Thorac Cardiovasc Surg. 2006;18(2):165–74. doi: 10.1053/j.semtcvs.2006.08.002.PubMedCrossRefGoogle Scholar
  14. 14.
    Grube E, et al. First report on a human percutaneous transluminal implantation of a self-expanding valve prosthesis for interventional treatment of aortic valve stenosis. Catheter Cardiovasc Interv. 2005;66(4):465–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Jilaihawi H, Asgar A, Bonan R. Good outcome and valve function despite Medtronic-CoreValve underexpansion. Catheter Cardiovasc Interv. 2010;76(7):1022–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Genereux P, Kodali S, Leon MB, Smith CR, Ben-Gal Y, Kirtane AJ, et al. Clinical outcomes using a new crossover balloon occlusion technique for percutaneous closure after transfemoral aortic valve implantation. JACC Cardiovasc Interv. 2011;4(8):861–7. doi: 10.1016/j.jcin.2011.05.019.PubMedCrossRefGoogle Scholar
  17. 17.
    Makkar RR, Fontana GP, Jilaihawi H, Kapadia S, Pichard AD, Douglas PS, et al. Transcatheter aortic-valve replacement for inoperable severe aortic stenosis. N Engl J Med. 2012;366(18):1696–704. doi: 10.1056/NEJMoa1202277.PubMedCrossRefGoogle Scholar
  18. 18.
    Kodali SK, Williams MR, Smith CR, Svensson LG, Webb JG, Makkar RR, et al. Two-year outcomes after transcatheter or surgical aortic-valve replacement. N Engl J Med. 2012;366(18):1686–95. doi: 10.1056/NEJMoa1200384.PubMedCrossRefGoogle Scholar
  19. 19.
    Piazza N, de Jaegere P, Schultz C, Becker AE, Serruys PW, Anderson RH. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovas Interv. 2008;1:74–81.CrossRefGoogle Scholar
  20. 20.
    Nuis RJ, et al. Timing and potential mechanisms of new conduction abnormalities during the implantation of the Medtronic CoreValve System in patients with aortic stenosis. Eur Heart J. 2011;32(16):2067–74.PubMedCrossRefGoogle Scholar
  21. 21.
    Buellesfeld L, et al. 2-year follow-up of patients undergoing transcatheter aortic valve implantation using a self-expanding valve prosthesis. J Am Coll Cardiol. 2011;57(16):1650–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Tamburino C, et al. Incidence and predictors of early and late mortality after transcatheter aortic valve implantation in 663 patients with severe aortic stenosis. Circulation. 2011;123(3):299–308.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Transcatheter Valve Therapy ClinicInstitut de Cardiologie de MontrealMontrealCanada
  2. 2.Department of MedicineMontreal Heart InstituteMontrealCanada

Personalised recommendations