Key result
Endovascular resection of the native aortic valve before transcatheter aortic valve implantation is an experimental approach being developed to prevent complications from residual calcified valves.
Why the study?
Does endovascular resection of the native aortic valve before transcatheter aortic valve implantation prevent complications in patients with symptomatic severe aortic stenosis?
Does endovascular resection of the native aortic valve before transcatheter aortic valve implantation prevent complications in patients with symptomatic severe aortic stenosis?
This review highlights experimental techniques for resecting the native aortic valve prior to TAVI to potentially reduce complications like paravalvular leak and coronary occlusion.
Answers are grounded in this paper and cite their sources.
Premature for clinical use in TAVI; leaves open whether endovascular resection reduces paravalvular leak or coronary occlusion.
Transcatheter aortic valve implantation was introduced into clinical practice in 2002 as a rescue approach in patients presenting with symptomatic severe aortic stenosis but not eligible for conventional aortic valve replacement. This technique allows implantation of a balloon expandable bioprosthesis without resection of the native aortic valve. Several complications are described as a consequence of the residual highly calcified valve being squeezed against the aortic wall by the stent of the implant. This can result in deformation of the metal stent and paravalvular leakage, risk of occlusion of the coronary ostia, or central and peripheral embolization of valvular debris. To avoid these complications, many authors suggest the possibility to resect and remove the native aortic valve before transcatheter aortic valve implantation. In this field, different authors have described possible techniques and different sources of energy to resect the calcified valve. In this article, we review the development of these experimental techniques and discuss future prospects in this field.
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Navarra et al. (2016) conducted a review in Symptomatic severe aortic stenosis. Endovascular resection of the native aortic valve before transcatheter aortic valve implantation was evaluated. Endovascular resection of the native aortic valve before transcatheter aortic valve implantation is an experimental approach being developed to prevent complications from residual calcified valves.
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