Evolving Devices and Material in Transcatheter Aortic Valve Replacement: What to Use and for Whom

Mauro Chiarito, Alessandro Spirito, Johny Nicolas, Alexandra Selberg, Giulio Stefanini, Antonio Colombo, Bernhard Reimers, Annapoorna Kini, Samin K. Sharma, George D. Dangas, Roxana Mehran

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis, providing a viable alternative to surgical aortic valve replacement (SAVR) for patients deemed to be at prohibitive surgical risk, but also for selected patients at intermediate or low surgical risk. Nonetheless, there still exist uncertainties regarding the optimal management of patients undergoing TAVR. The selection of the optimal bioprosthetic valve for each patient represents one of the most challenging dilemmas for clinicians, given the large number of currently available devices. Limited follow-up data from landmark clinical trials comparing TAVR with SAVR, coupled with the typically elderly and frail population of patients undergoing TAVR, has led to inconclusive data on valve durability. Recommendations about the use of one device over another in given each patient’s clinical and procedural characteristics are largely based on expert consensus. This review aims to evaluate the available evidence on the performance of different devices in the presence of specific clinical and anatomic features, with a focus on patient, procedural, and device features that have demonstrated a relevant impact on the risk of poor hemodynamic valve performance and adverse clinical events.

Original languageEnglish
Article number4445
JournalJournal of Clinical Medicine
Volume11
Issue number15
DOIs
StatePublished - Aug 2022

Keywords

  • aortic regurgitation
  • aortic stenosis
  • balloon-expandable valve
  • self-expanding valve
  • transcatheter aortic valve replacement
  • transcatheter heart valve

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