Cardiac multislice computed tomography after transcatheter aortic valve implantation: Features after "valve-in-valve" implantation for degenerative stented aortic bioprosthesis

Department of Radiology, University Hospital of Rouen, Rouen cedex, France.
Archives of cardiovascular diseases (Impact Factor: 1.84). 03/2012; 105(3):190-2. DOI: 10.1016/j.acvd.2011.07.005
Source: PubMed
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Available from: Jérôme Caudron, Mar 12, 2014
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    ABSTRACT: Since the first clinical implantation in 2002, transcatheter aortic valve implantation (TAVI) or replacement (TAVR) has become an established therapy in the treatment of symptomatic severe aortic stenosis in patients deemed too high risk for surgical aortic valve replacement (SAVR). With over 50,000 implants performed in more than 40 countries, a large amount of clinical data have emerged in this rapidly growing field. Careful patient selection, systematic risk stratification, optimal valve sizing, meticulous procedural techniques, and complications management are all important elements to achieve good outcomes. However, several critical issues exist with TAVR that need to be addressed before it can become more widely adopted. Quality of life improvement and cost effectiveness of TAVR, when compared to SAVR, remain uncertain in lower risk patients. Stroke, PVL, vascular complication, bleeding and heart block represent only a few of the key concerns in this therapy. Valve-in-valve procedures are becoming a novel application of transcatheter heart valve in the treatment of a degenerated bioprosthesis, and next generation heart valves that address some of these ongoing issues are currently under evaluation. Future prospective studies will allow us to refine this therapy and optimize outcomes in this high risk patient population.
    No preview · Article · Dec 2012 · Cardiology in review
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    ABSTRACT: Transcatheter aortic valve replacement (TAVR) has emerged as an accepted indication for non-operable patients with severe symptomatic native aortic valve stenosis (AS) and as a reasonable alternative for high-risk surgical AS patients. Nonetheless, the safety and efficacy of performing TAVR in several other potential indications are yet unclear. In the present manuscript the authors review the current evidence supporting TAVR for other potential indications than the typical high-risk/non-operable AS patients, providing updated results of the main clinical trials and registries exploring these particular indications. Finally, the authors provide practical recommendations for TAVR in each of these conditions.
    No preview · Article · May 2014 · Expert Review of Cardiovascular Therapy