Transcatheter aortic valve implantation (TAVI): state of the art techniques and future perspectives.

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State: Serval
Version: Final published version
Serval ID
serval:BIB_7C24248DE1FC
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Transcatheter aortic valve implantation (TAVI): state of the art techniques and future perspectives.
Journal
Swiss medical weekly
Author(s)
Ferrari E., von Segesser L.K.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
01/12/2010
Peer-reviewed
Oui
Volume
140
Pages
w13127
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
Transcatheter aortic valve therapies are the newest established techniques for the treatment of high risk patients affected by severe symptomatic aortic valve stenosis. The transapical approach requires a left anterolateral mini-thoracotomy, whereas the transfemoral method requires an adequate peripheral vascular access and can be performed fully percutaneously. Alternatively, the trans-subclavian access has been recently proposed as a third promising approach. Depending on the technique, the fine stent-valve positioning can be performed with or without contrast injections. The transapical echo-guided stent-valve implantation without angiography (the Lausanne technique) relies entirely on transoesophageal echocardiogramme imaging for the fine stent-valve positioning and it has been proved that this technique prevents the onset of postoperative contrast-related acute kidney failure. Recent published reports have shown good hospital outcomes and short-term results after transcatheter aortic valve implantation, but there are no proven advantages in using the transfemoral or the transapical technique. In particular, the transapical series have a higher mean logistic Euroscore of 27-35%, a procedural success rate above 95% and a mean 30-day mortality between 7.5 and 17.5%, whereas the transfemoral results show a lower logistic Euroscore of 23-25.5%, a procedural success rate above 90% and a 30-day mortality of 7-10.8%. Nevertheless, further clinical trials and long-term results are mandatory to confirm this positive trend. Future perspectives in transcatheter aortic valve therapies would be the development of intravascular devices for the ablation of the diseased valve leaflets and the launch of new stent-valves with improved haemodynamic, different sizes and smaller delivery systems.

Keywords
Aortic Valve/surgery, Catheterization, Forecasting, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation/methods, Heart Valve Prosthesis Implantation/trends, Humans, Patient Selection, Prosthesis Design, Treatment Outcome
Pubmed
Open Access
Yes
Create date
18/03/2011 10:48
Last modification date
08/05/2019 20:52
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