Percutaneous aortic valve replacement
|Percutaneous aortic valve replacement|
In Percutaneous aortic valve replacement or Transcatheter Aortic Valve Implantation (TAVI) or Transcatheter Aortic Valve Replacement (TAVR), a replacement valve is delivered via a catheter using one of several access methods: transfemoral (in the upper leg), transapical (through the wall of the heart), subclavian (beneath the collar bone) and direct aortic (through a minimally invasive surgical incision into the aorta).
The catheter procedure was developed in Europe, initially performed in 2002 on April 16th by Prof Alain Cribier in Hopital Charles Nicolle, Rouen, France.  It is now approved in more than 50 countries. It is effective in improving functioning in the patients with severe aortic stenosis. In the US, it received FDA approval in November 2011 for use in inoperable patients and in October 2012 for use in patients at high surgical risk.
In high-risk patients with severe aortic stenosis, transcatheter and surgical procedures for aortic-valve replacement had similar rates of survival at 1 year, although there were important differences in risks associated with the procedure.
In 2010 good results (20% better 1 year survival) were reported from a US trial on 358 patients.
There are two current market leaders whose devices have earned CE Mark approval in Europe and are available to physicians for implantation in appropriate patients; the Medtronic CoreValve device (a self-expanding valve prosthesis consisting of a Nickel-titanium frame with a tri-leaflet valve fashioned out of porcine pericardium mounted within) and the SAPIEN device by Edwards Lifesciences (a balloon-expandable tubular metal stent with a tri-leaflet valve fashioned out of bovine pericardium mounted within). Only the latter device is currently FDA-approved in the USA.
- Cribier, A; Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, Derumeaux G, Anselme F, Laborde F, Leon MB (10). "Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis. First human case description.". Circulation 106 (24): 3006–3008. PMID 12473543.
- Smith, Craig R.; et al. (2 June 2011). "Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk Patients". N Engl J Med 364: 2187–2198. doi:10.1056/NEJMoa1103510. PMID 21639811.
- "New Procedure for Aortic Valve Replacement Looks Promising". 22 September 2010.
“Novel stent design for Percutaneous aortic valve replacement” - G.V.P Kumar & L.Mathew, IFMBE Proceedings, Springerlink,4th Kuala Lumpur International Conference on Biomedical Engineering 25–28 June 2008, Pages 446-448.
“New Stent Design for Percutaneous Aortic Valve Replacement” - Gideon Praveen Kumar & Lazar Mathew International Journal of Cardiovascular Revascularization Medicine, (2009), volume 10, issue 2, Pages 121 – 124
“Effects of Stent Design Parameters on the Aortic Endothelium" – Gideon Praveen Kumar & Lazar Mathew IFMBE Series, 13th International Conference on Biomedical Engineering, Singapore, 3–6 December 2008, volume 23, Pages 1539–1542
- van Herwerden L, Serruys P (2002). "Percutaneous valve implantation: back to the future?". Eur Heart J 23 (18): 1415–6. doi:10.1053/euhj.2002.3305. PMID 12208220.
- de Jaegere, Peter; Arie Pieter Kappetein; Marco Knook; Ben Ilmer; Dries van der Woerd; Yvon Deryck; Marjo de Ronde; Ricardo Boks; G. Sianos; Jurgen Ligthart; Jean-Claude Laborde; Ad Bogers; Patrick W. Serruys. "Percutaneous aortic valve replacement in a patient who could not undergo surgical treatment. A case report with the CoreValve aortic valve prosthesis.". EuroInterv 2006. pp. 1:475–479. Retrieved 18 October 2006.
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