Skip to main content

Transcatheter Aortic Valve Replacement: An Interventionist’s View

  • Chapter
  • First Online:
Multimodality Imaging for Transcatheter Aortic Valve Replacement

Abstract

Calcific aortic stenosis is the most common acquired valvular heart disease, and its prevalence is increasing significantly with the aging population. Once symptoms of angina, syncope, or heart failure develop, average survival is 2–3 years [1]. Traditionally, surgical aortic valve replacement (SAVR) has been the definitive treatment for severe symptomatic aortic stenosis; however, many patients do not undergo surgery as they are considered high risk or inoperable due to age and comorbidities [2].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 159.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 209.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bonow RO, Carabello BA, Kanu C, de Leon Jr AC, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O’Gara PT, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation. 2006;114(5):e84–231.

    Article  PubMed  Google Scholar 

  2. Bouma BJ, van der Meulen JH, van den Brink RB, Arnold AE, Smidts A, Teunter LH, Lie KI, Tijssen JG. Variability in treatment advice for elderly patients with aortic stenosis: a nationwide survey in The Netherlands. Heart. 2001;85(2):196–201.

    Article  PubMed  CAS  Google Scholar 

  3. Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, Derumeaux G, Anselme F, Laborde F, Leon MB. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation. 2002;106(24):3006–8.

    Article  PubMed  Google Scholar 

  4. Webb JG, Chandavimol M, Thompson CR, Ricci DR, Carere RG, Munt BI, Buller CE, Pasupati S, Lichtenstein S. Percutaneous aortic valve implantation retrograde from the femoral artery. Circulation. 2006;113(6):842–50.

    Article  PubMed  Google Scholar 

  5. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597–607.

    Article  PubMed  CAS  Google Scholar 

  6. Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187–98.

    Article  PubMed  CAS  Google Scholar 

  7. Lichtenstein SV, Cheung A, Ye J, Thompson CR, Carere RG, Pasupati S, Webb JG. Transapical transcatheter aortic valve implantation in humans: initial clinical experience. Circulation. 2006;114(6):591–6.

    Article  PubMed  Google Scholar 

  8. Rodes-Cabau J. Progress in transcatheter aortic valve implantation. Rev Esp Cardiol. 2010;63(4):439–50.

    Article  PubMed  Google Scholar 

  9. Vahanian A, Alfieri O, Al-Attar N, Antunes M, Bax J, Cormier B, Cribier A, De Jaegere P, Fournial G, Kappetein AP, et al. Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2008;29(11):1463–70.

    Article  PubMed  Google Scholar 

  10. Modine T, Obadia JF, Choukroun E, Rioufoul G, Sudre A, Laborde JC, Leprince P. Transcutaneous aortic valve implantation using the axillary/subclavian access: feasibility and early clinical outcomes. J Thorac Cardiovasc Surg. 2011;141(2):487–91, 491 e1.

    Article  PubMed  Google Scholar 

  11. Bruschi G, Fratto P, De Marco F, Oreglia J, Colombo P, Botta L, Cannata A, Moreo A, De Chiara B, Lullo F, et al. The trans-subclavian retrograde approach for transcatheter aortic valve replacement: single-center experience. J Thorac Cardiovasc Surg. 2010;140(4):911–5, 915 e1–2.

    Article  PubMed  Google Scholar 

  12. Bapat V, Thomas M, Hancock J, Wilson K. First successful trans-catheter aortic valve implantation through ascending aorta using Edwards SAPIEN THV system. Eur J Cardiothorac Surg. 2010;38(6):811–3.

    Article  PubMed  Google Scholar 

  13. Latsios G, Gerckens U, Grube E. Transaortic transcatheter aortic valve implantation: a novel approach for the truly "no-access option" patients. Catheter Cardiovasc Interv. 2010;75(7):1129–36.

    PubMed  Google Scholar 

  14. Toggweiler S, Gurvitch R, Leipsic J, Wood DA, Willson AB, Binder RK, Cheung A, Ye J, Webb JG. Percutaneous aortic valve replacement vascular outcomes with a fully percutaneous procedure. J Am Coll Cardiol. 2012;59(2):113–8.

    Article  PubMed  Google Scholar 

  15. Falk V, Walther T, Schwammenthal E, Strauch J, Aicher D, Wahlers T, Schafers J, Linke A, Mohr FW. Transapical aortic valve implantation with a self-expanding anatomically oriented valve. Eur Heart J. 2011;32(7):878–87.

    Article  PubMed  CAS  Google Scholar 

  16. Lauten A, Ferrari M, Petri A, Ensminger SM, Gummert JF, Boudjemline Y, Schubert H, Schumm J, Hekmat K, Schlosser M, et al. Experimental evaluation of the JenaClip transcatheter aortic valve. Catheter Cardiovasc Interv. 2009;74(3):514–9.

    Article  PubMed  Google Scholar 

  17. Kempfert J, Rastan AJ, Mohr FW, Walther T. A new self-expanding transcatheter aortic valve for transapical implantation – first in man implantation of the JenaValve. Eur J Cardiothorac Surg. 2011;40(3):761–3.

    PubMed  Google Scholar 

  18. Schofer J, Schluter M, Treede H, Franzen OW, Tubler T, Pascotto A, Low RI, Bolling SF, Meinertz T, Reichenspurner H. Retrograde transarterial implantation of a nonmetallic aortic valve prosthesis in high-surgical-risk patients with severe aortic stenosis: a first-in-man feasibility and safety study. Circ Cardiovasc Interv. 2008;1(2):126–33.

    Article  PubMed  Google Scholar 

  19. Treede H, Tubler T, Reichenspurner H, Grube E, Pascotto A, Franzen O, Mueller R, Low R, Bolling SF, Meinertz T, et al. Six-month results of a repositionable and retrievable pericardial valve for transcatheter aortic valve replacement: the Direct Flow Medical aortic valve. J Thorac Cardiovasc Surg. 2010;140(4):897–903.

    Article  PubMed  Google Scholar 

  20. Holmes Jr DR, Mack MJ. Transcatheter valve therapy a professional society overview from the american college of cardiology foundation and the society of thoracic surgeons. J Am Coll Cardiol. 2011;58(4):445–55.

    Article  PubMed  Google Scholar 

  21. Leon MB, Piazza N, Nikolsky E, Blackstone EH, Cutlip DE, Kappetein AP, Krucoff MW, Mack M, Mehran R, Miller C, et al. Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials: a consensus report from the Valve Academic Research Consortium. J Am Coll Cardiol. 2011;57(3):253–69.

    Article  PubMed  Google Scholar 

  22. Nuis RJ, Piazza N, Van Mieghem NM, Otten AM, Tzikas A, Schultz CJ, van der Boon R, van Geuns RJ, van Domburg RT, Koudstaal PJ, et al. In-hospital complications after transcatheter aortic valve implantation revisited according to the valve academic research consortium definitions. Catheter Cardiovasc Interv. 2011;78(3):457–67.

    PubMed  Google Scholar 

  23. Grube E, Schuler G, Buellesfeld L, Gerckens U, Linke A, Wenaweser P, Sauren B, Mohr FW, Walther T, Zickmann B, et al. Percutaneous aortic valve replacement for severe aortic stenosis in high-risk patients using the second- and current third-generation self-expanding CoreValve prosthesis: device success and 30-day clinical outcome. J Am Coll Cardiol. 2007;50(1):69–76.

    Article  PubMed  Google Scholar 

  24. Himbert D, Descoutures F, Al-Attar N, Iung B, Ducrocq G, Detaint D, Brochet E, Messika-Zeitoun D, Francis F, Ibrahim H, et al. Results of transfemoral or transapical aortic valve implantation following a uniform assessment in high-risk patients with aortic stenosis. J Am Coll Cardiol. 2009;54(4):303–11.

    Article  PubMed  Google Scholar 

  25. Lefevre T, Kappetein AP, Wolner E, Nataf P, Thomas M, Schachinger V, De Bruyne B, Eltchaninoff H, Thielmann M, Himbert D, et al. One year follow-up of the multi-centre European PARTNER transcatheter heart valve study. Eur Heart J. 2011;32(2):148–57.

    Article  PubMed  Google Scholar 

  26. Kahlert P, Knipp SC, Schlamann M, Thielmann M, Al-Rashid F, Weber M, Johansson U, Wendt D, Jakob HG, Forsting M, et al. Silent and apparent cerebral ischemia after percutaneous transfemoral aortic valve implantation: a diffusion-weighted magnetic resonance imaging study. Circulation. 2010;121(7):870–8.

    Article  PubMed  Google Scholar 

  27. Naber CK, Ghanem A, Abizaid AA, Wolf A, Sinning JM, Werner N, Nickenig G, Schmitz T, Grube E. First-in-man use of a novel embolic protection device for patients undergoing transcatheter aortic valve implantation. EuroIntervention. 2012;8(1):43–50.

    Article  PubMed  Google Scholar 

  28. Carpenter JP, Carpenter JT, Tellez A, Webb JG, Yi GH, Granada JF. A percutaneous aortic device for cerebral embolic protection during cardiovascular intervention. J Vasc Surg. 2011;54(1):174–181 e1.

    Article  PubMed  Google Scholar 

  29. Webb JG. Coronary obstruction due to transcatheter valve implantation. Catheter Cardiovasc Interv. 2009;73(7):973.

    Article  PubMed  Google Scholar 

  30. Al Ali AM, Altwegg L, Horlick EM, Feindel C, Thompson CR, Cheung A, Carere RG, Humphries K, Ye J, Masson JB, et al. Prevention and management of transcatheter balloon-expandable aortic valve malposition. Catheter Cardiovasc Interv. 2008;72(4):573–8.

    Article  PubMed  Google Scholar 

  31. Thomas M, Schymik G, Walther T, Himbert D, Lefevre T, Treede H, Eggebrecht H, Rubino P, Michev I, Lange R, et al. Thirty-day results of the SAPIEN aortic Bioprosthesis European Outcome (SOURCE) Registry: a European registry of transcatheter aortic valve implantation using the Edwards SAPIEN valve. Circulation. 2010;122(1):62–9.

    Article  PubMed  Google Scholar 

  32. Bagur R, Webb JG, Nietlispach F, Dumont E, De Larochelliere R, Doyle D, Masson JB, Gutierrez MJ, Clavel MA, Bertrand OF, et al. Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement. Eur Heart J. 2010;31(7):865–74.

    Article  PubMed  Google Scholar 

  33. Piazza N, de Jaegere P, Schultz C, Becker AE, Serruys PW, Anderson RH. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovasc Interv. 2008;1(1):74–81.

    Article  PubMed  Google Scholar 

  34. Godin M, Eltchaninoff H, Furuta A, Tron C, Anselme F, Bejar K, Sanchez-Giron C, Bauer F, Litzler PY, Bessou JP, et al. Frequency of conduction disturbances after transcatheter implantation of an Edwards Sapien aortic valve prosthesis. Am J Cardiol. 2010;106(5):707–12.

    Article  PubMed  Google Scholar 

  35. Sinhal A, Altwegg L, Pasupati S, Humphries KH, Allard M, Martin P, Cheung A, Ye J, Kerr C, Lichtenstein SV, et al. Atrioventricular block after transcatheter balloon expandable aortic valve implantation. JACC Cardiovasc Interv. 2008;1(3):305–9.

    Article  PubMed  Google Scholar 

  36. Eltchaninoff H, Prat A, Gilard M, Leguerrier A, Blanchard D, Fournial G, Iung B, Donzeau-Gouge P, Tribouilloy C, Debrux JL, et al. Transcatheter aortic valve implantation: early results of the FRANCE (FRench Aortic National CoreValve and Edwards) registry. Eur Heart J. 2011;32(2):191–7.

    Article  PubMed  Google Scholar 

  37. Bleiziffer S, Ruge H, Horer J, Hutter A, Geisbusch S, Brockmann G, Mazzitelli D, Bauernschmitt R, Lange R. Predictors for new-onset complete heart block after transcatheter aortic valve implantation. JACC Cardiovasc Interv. 2010;3(5):524–30.

    Article  PubMed  Google Scholar 

  38. Baan Jr J, Yong ZY, Koch KT, Henriques JP, Bouma BJ, Vis MM, Cocchieri R, Piek JJ, de Mol BA. Factors associated with cardiac conduction disorders and permanent pacemaker implantation after percutaneous aortic valve implantation with the CoreValve prosthesis. Am Heart J. 2010;159(3):497–503.

    Article  PubMed  Google Scholar 

  39. Piazza N, Nuis RJ, Tzikas A, Otten A, Onuma Y, Garcia-Garcia H, Schultz C, van Domburg R, van Es GA, van Geuns R, et al. Persistent conduction abnormalities and requirements for pacemaking six months after transcatheter aortic valve implantation. EuroIntervention. 2010;6(4):475–84.

    Article  PubMed  Google Scholar 

  40. Pibarot P, Dumesnil JG. Prosthesis-patient mismatch: definition, clinical impact, and prevention. Heart. 2006;92(8):1022–9.

    Article  PubMed  CAS  Google Scholar 

  41. Tzikas A, Piazza N, Geleijnse ML, Van Mieghem N, Nuis RJ, Schultz C, van Geuns RJ, Galema TW, Kappetein AP, Serruys PW, et al. Prosthesis-patient mismatch after transcatheter aortic valve implantation with the medtronic CoreValve system in patients with aortic stenosis. Am J Cardiol. 2010;106(2):255–60.

    Article  PubMed  Google Scholar 

  42. Jilaihawi H, Chin D, Spyt T, Jeilan M, Vasa-Nicotera M, Bence J, Logtens E, Kovac J. Prosthesis-patient mismatch after transcatheter aortic valve implantation with the Medtronic-Corevalve bioprosthesis. Eur Heart J. 2010;31(7):857–64.

    Article  PubMed  Google Scholar 

  43. Ewe SH, Muratori M, Delgado V, Pepi M, Tamborini G, Fusini L, Klautz RJ, Gripari P, Bax JJ, Fusari M, et al. Hemodynamic and clinical impact of prosthesis-patient mismatch after transcatheter aortic valve implantation. J Am Coll Cardiol. 2011;58(18):1910–8.

    Article  PubMed  Google Scholar 

  44. Clavel MA, Webb JG, Pibarot P, Altwegg L, Dumont E, Thompson C, De Larochelliere R, Doyle D, Masson JB, Bergeron S, et al. Comparison of the hemodynamic performance of percutaneous and surgical bioprostheses for the treatment of severe aortic stenosis. J Am Coll Cardiol. 2009;53(20):1883–91.

    Article  PubMed  Google Scholar 

  45. Rodes-Cabau J, Webb JG, Cheung A, Ye J, Dumont E, Feindel CM, Osten M, Natarajan MK, Velianou JL, Martucci G, et al. Transcatheter aortic valve implantation for the treatment of severe symptomatic aortic stenosis in patients at very high or prohibitive surgical risk: acute and late outcomes of the multicenter Canadian experience. J Am Coll Cardiol. 2010;55(11):1080–90.

    Article  PubMed  Google Scholar 

  46. Abdel-Wahab M, Zahn R, Horack M, Gerckens U, Schuler G, Sievert H, Eggebrecht H, Senges J, Richardt G. Aortic regurgitation after transcatheter aortic valve implantation: incidence and early outcome. Results from the German transcatheter aortic valve interventions registry. Heart. 2011;97(11):899–906.

    Article  PubMed  Google Scholar 

  47. Piazza N, Marra S, Webb J, D’Amico M, Rinaldi M, Boffini M, Comoglio C, Scacciatella P, Kappetein AP, de Jaegere P, et al. Two cases of aneurysm of the anterior mitral valve leaflet associated with transcatheter aortic valve endocarditis: a mere coincidence? J Thorac Cardiovasc Surg. 2010;140(3):e36–8.

    Article  PubMed  Google Scholar 

  48. Trepels T, Martens S, Doss M, Fichtlscherer S, Schachinger V. Images in cardiovascular medicine. Thrombotic restenosis after minimally invasive implantation of aortic valve stent. Circulation. 2009;120(4):e23–4.

    Article  PubMed  Google Scholar 

  49. Wong DR, Boone RH, Thompson CR, Allard MF, Altwegg L, Carere RG, Cheung A, Ye J, Lichtenstein SV, Ling H, et al. Mitral valve injury late after transcatheter aortic valve implantation. J Thorac Cardiovasc Surg. 2009;137(6):1547–9.

    Article  PubMed  Google Scholar 

  50. Webb JG, Wood DA, Ye J, Gurvitch R, Masson JB, Rodes-Cabau J, Osten M, Horlick E, Wendler O, Dumont E, et al. Transcatheter valve-in-valve implantation for failed bioprosthetic heart valves. Circulation. 2010;121(16):1848–57.

    Article  PubMed  Google Scholar 

  51. Piazza N, Bleiziffer S, Brockmann G, Hendrick R, Deutsch MA, Opitz A, Mazzitelli D, Tassani-Prell P, Schreiber C, Lange R. Transcatheter aortic valve implantation for failing surgical aortic bioprosthetic valve: from concept to clinical application and evaluation (part 2). JACC Cardiovasc Interv. 2011;4(7):733–42.

    Article  PubMed  Google Scholar 

  52. Piazza N, Bleiziffer S, Brockmann G, Hendrick R, Deutsch MA, Opitz A, Mazzitelli D, Tassani-Prell P, Schreiber C, Lange R. Transcatheter aortic valve implantation for failing surgical aortic bioprosthetic valve: from concept to clinical application and evaluation (part 1). JACC Cardiovasc Interv. 2011;4(7):721–32.

    Article  PubMed  Google Scholar 

  53. Gurvitch RCA, Ye J, Wood DA, Willson AB, Toggweiler S, Binder R, Webb JG. Transcatheter valve-in-valve implantation for failed surgical bioprosthetic valves. J Am Coll Cardiol. 2011;58:2196–209.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Melanie Freeman MBBS, FRACP .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Freeman, M., Webb, J.G. (2014). Transcatheter Aortic Valve Replacement: An Interventionist’s View. In: Min, J., Berman, D., Leipsic, J. (eds) Multimodality Imaging for Transcatheter Aortic Valve Replacement. Springer, London. https://doi.org/10.1007/978-1-4471-2798-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2798-7_4

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2797-0

  • Online ISBN: 978-1-4471-2798-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics