Abstract
Transcatheter aortic valve replacement (TAVR) is a well-established treatment for
patients with severe symptomatic aortic stenosis who are at high or prohibitive surgical
risk. More recently, TAVR has emerged as a valid alternative to surgical aortic valve
replacement for treating intermediate-risk patients, and several studies are currently
evaluating the role of TAVR in low-risk patients. Transcatheter heart valve (THV)
technologies have evolved considerably over time, and important iterations have been
implemented in many of the latest-generation devices to (1) reduce the size and improve
delivery system properties; (2) improve valve deployment, repositioning, and retrievability;
and (3) reduce paravalvular leaks. This article reviews the main characteristics of,
and clinical results associated with, the newer-generation THVs while providing an
overview of novel TAVR indications.
Résumé
Le remplacement valvulaire aortique par cathéter (RVAC) est un traitement qui a fait
ses preuves chez les patients atteints de sténose aortique symptomatique grave qui
présentent un risque chirurgical élevé ou prohibitif. Depuis peu, le RVAC constitue
une solution de rechange valable à l’implantation valvulaire aortique chirurgicale
chez les patients présentant un risque intermédiaire, et plusieurs études visant à
évaluer le rôle du RVAC chez les patients présentant un faible risque sont en cours.
Les technologies valvulaires percutanées (TVP) ont considérablement évolué au fil
du temps, et des variantes importantes ont été mises en œuvre dans bon nombre de dispositifs
de dernière génération afin de 1) réduire leur taille et améliorer les propriétés
des systèmes d’implantation; 2) améliorer le déploiement, le repositionnement et la
possibilité de retrait des valves; et 3) limiter les fuites paravalvulaires. Cet article
passe en revue les principales caractéristiques des TVP de nouvelle génération et
les résultats cliniques qui leur sont associés, tout en offrant un aperçu des nouvelles
indications du RVAC.
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Article info
Publication history
Published online: March 24, 2017
Accepted:
March 13,
2017
Received:
January 13,
2017
Footnotes
See page 1089 for disclosure information.
Identification
Copyright
© 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
