Percutaneous aortic valve replacement

Percutaneous aortic valve replacement
Intervention
ICD-9-CM	35.21-35.22, 35.96

In Percutaneous aortic valve replacement or Transcatheter Aortic Valve Implantation (TAVI), a replacement valve is passed through a hole in the groin by a puncture of the femoral artery and advanced up to the ascending aorta of the patient. It substitutes for a more invasive procedure in which the chest is opened. The survival is equivalent, but the risk of stroke is higher.

The catheter procedure was developed in Europe, initially performed in 2002. It is effective in improving functioning in the patients with severe aortic stenosis. It is still in clinical trial testing in the United States, and has not been approved by the FDA.

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.^[1] The transcatheter procedure was associated with a higher risk of stroke than the surgical replacement (5.5% vs. 2.4% after 30 days; 8.3% vs. 4.3% after 1 year).^[2]

In 2010 good results (20% better 1 year survival) were reported from a US trial on 358 patients.^[3] The procedure was called transcatheter aortic-valve implantation (TAVI) and implanted cow heart valves.

Devices

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 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 percardium mounted within).

References

1. ^ Smith, Craig R.; et al. (June 2, 2011). "Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk Patients". N Engl J Med 364: 2187–2198. doi:10.1056/NEJMoa1103510. http://www.nejm.org/doi/full/10.1056/NEJMoa1103510. 
2. ^ Schaff, Hartzell V. (June 2, 2011). "Transcatheter Aortic-Valve Implantation — At What Price?". N Engl J Med 364: 2256–2258. doi:10.1056/NEJMe1103978. http://www.nejm.org/doi/full/10.1056/NEJMe1103978. 
3. ^ "New Procedure for Aortic Valve Replacement Looks Promising". 22 Sept 2010. http://www.nlm.nih.gov/medlineplus/news/fullstory_103606.html. 

“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.

“Design for Percutaneous Aortic Valve Stent” – Gideon PraveenKumar & Dr.Lazar Mathew, International Conference on Biotechnology Proceedings, VIT University, Feb 8th 2008, Pages 139-140

“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

Further reading

• 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. http://www.europcronline.com/eurointervention/4th_issue/79/?ind=1. Retrieved 2006-10-18. 

This medical treatment-related article is a stub. You can help Wikipedia by expanding it.v · Categories: Cardiac procedures Medical treatment stubs Wikimedia Foundation. 2010. Игры ⚽ Нужен реферат? Lohana Berkins Khaleej Sirt Look at other dictionaries: Aortic valve replacement — is a cardiac surgery procedure in which a patient s aortic valve is replaced by a different valve. The aortic valve can be affected by a range of diseases; the valve can either become leaky (aortic insufficiency / regurgitation) or partially… …   Wikipedia Aortic valve stenosis — Classification and external resources ICD 10 I35.0, I06.0, Q23.0 …   Wikipedia Valve-sparing aortic root replacement — (also known as the David procedure) is a cardiac surgery procedure involving replacement of the aortic root without replacement of the aortic valve. Two similar procedures were developed, one by Sir Magdi Yacoub,[1] and another by Tirone David.… …   Wikipedia Mitral valve replacement — Intervention ICD 9 CM 35.23 35.24 Mitral valve replacement is a cardiac surgery …   Wikipedia Percutaneous coronary intervention — Intervention A coronary angiogram (an X ray with radio opaque contrast in the coronary arteries) that shows the left coronary circulation. The distal left main coronary artery (LMCA) is in the left upper quadrant of the image. Its main branches… …   Wikipedia Aortic valvuloplasty — is the repair of a stenotic aortic valve using a balloon catheter inside the valve. The balloon is placed into the aortic valve that has become stiff from calcium buildup. The balloon is then inflated in an effort to increase the opening size of… …   Wikipedia Aortic insufficiency — See also: mitral regurgitation and tricuspid insufficiency Aortic insufficiency Classification and external resources Micrograph of myxomatous degeneration – a cause of aortic insufficiency …   Wikipedia Mitral valve repair — Intervention Anterior (frontal) view of the opened heart. White arrows indicate normal blood flow. (Mitral valve labeled at center right.) ICD 9 CM …   Wikipedia Heart valve repair — Intervention ICD 9 CM 35.0 35.2 Heart valve repair is a surgical technique used to fix defects in …   Wikipedia Artificial heart valve — An artificial heart valve is a device implanted in the heart of a patient with heart valvular disease. When one of the four heart valves malfunctions, the medical choice may be to replace the natural valve with an artificial valve. This requires… …   Wikipedia 18+ © Academic, 2000-2024 Contact us: Technical Support, Advertising Dictionaries export, created on PHP, Joomla, Drupal, WordPress, MODx. Mark and share Search through all dictionaries Translate… Search Internet Share the article and excerpts Direct link … Do a right-click on the link above and select “Copy Link”