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

Détails

Ressource 1Télécharger: 21120735.pdf (1131.38 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_7C24248DE1FC
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Transcatheter aortic valve implantation (TAVI): state of the art techniques and future perspectives.
Périodique
Swiss medical weekly
Auteur(s)
Ferrari E., von Segesser L.K.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
01/12/2010
Peer-reviewed
Oui
Volume
140
Pages
w13127
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Résumé
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.

Mots-clé
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
Oui
Création de la notice
18/03/2011 10:48
Dernière modification de la notice
08/05/2019 20:52
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