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Safety and efficacy of repeat transcatheter aortic valve replacement for the treatment of transcatheter prosthesis dysfunction
- Source :
- Expert review of medical devices. 17(12)
- Publication Year :
- 2020
-
Abstract
- Introduction: Transcatheter aortic valve replacement (TAVR) has recently expanded toward the treatment of younger patients with lower surgical risk and longer life expectancy. Thus, transcatheter heart valve (THV) durability has become a central issue, and an important increase in the number of TAVR-in-TAVR is expected in the coming years. Areas covered: Overview of the current status of TAVR-in-TAVR for the treatment of THV dysfunction, focusing on safety and efficacy of repeat TAVR procedures. Expert opinion: An accurate analysis of the pre-procedure cardiac computed tomography, incorporating new parameters such as the position of the top of the first THV in relation to the sinotubular-junction, will be necessary to assess the risk of coronary occlusion. Subsequent coronary angiography will be necessary in a proportion of TAVR-in-TAVR patients, but coronary access may be very difficult or even impossible in some of them. Therefore, the choice between TAVR and SAVR in young low-risk patients should incorporate the potential need for treating coronary events at mid- to long-term follow-up. Likewise, the choice of the valve type and the implantation position at the time of the first TAVR procedure should take into account the possibility of TAVR-in-TAVR in the future.Abbreviations ACS: acute coronary syndrome; CO: coronary obstruction; EOA: effective orifice area; SAVR: surgical aortic valve replacement; SVD: structural valve degenerationTAVR: transcatheter aortic valve replacement; THV: transcatheter heart valve.
- Subjects :
- Coronary angiography
medicine.medical_specialty
Acute coronary syndrome
Transcatheter aortic
medicine.medical_treatment
Biomedical Engineering
030204 cardiovascular system & hematology
Prosthesis
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Valve replacement
Aortic valve replacement
Internal medicine
Medicine
Humans
Heart valve
Clinical Trials as Topic
business.industry
Hemodynamics
General Medicine
medicine.disease
medicine.anatomical_structure
Treatment Outcome
Coronary occlusion
Aortic Valve
Heart Valve Prosthesis
Cardiology
Surgery
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 17452422
- Volume :
- 17
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Expert review of medical devices
- Accession number :
- edsair.doi.dedup.....069e77b872f3bb6d9db818e6dc669c9e