Components of a Heart Catheter System for High Risk Patients

2016 ◽  
Vol 879 ◽  
pp. 583-588
Author(s):  
Gregor Gatomski ◽  
Hong Nhung Nguyen ◽  
Fabrizio Quadrini ◽  
Andreas H. Foitzik
Keyword(s):  
Heart Valves ◽  
Minimal Invasive ◽  
Linear Motion ◽  
Cardiac Defects ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
European Health ◽  
European Health Care System ◽  
Valve Implantation

As late as fifteen years ago the intracardiac catheter was only used for diagnostic purposes. Since then it has also been established as a therapeutic method. The latest studies have shown that the reduction in convalescence that normally follows a catheter-interventional implantation of aortic valves by transcatheter aortic valve implantation is less significant in comparison to that of a cardiac surgery operation. It is expected that such minimal-invasive technologies will grow to a great extent, also helping to reduce socio-economic costs for the European health care system. Patients of higher ages with acquired cardiac defects or children with congenital cardiac defects of heart valves, especially of the pulmonary valve, are currently the main target groups. We present an alternative and optimized mechanism for stent placement and similar therapeutical interventions. This project focuses on the manipulation unit and tube system. It carries out a highly precise and repeatable linear motion. Ergonomic requirements are taken into account. Furthermore a possibility to support the linear motion by minimal strain is presented. The product is designed for disposable applications but is generally also suitable for long-term applications.

scholarly journals Long-term Transcatheter Aortic Valve Durability

2019 ◽  
Vol 14 (2) ◽  
pp. 62-69 ◽  
Author(s):  
Giuliano Costa ◽  
Enrico Criscione ◽  
Denise Todaro ◽  
Corrado Tamburino ◽  
Marco Barbanti
Keyword(s):  
Aortic Valve ◽  
European Association ◽  
Standard Of Care ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
International Data ◽  
Valve In Valve ◽  
European Society Of Cardiology ◽  
Valve Implantation

Transcatheter aortic valve implantation (TAVI) has become the standard of care for high-risk and inoperable surgical patients and a valid alternative to surgery for low- and intermediate-risk patients with severe, symptomatic aortic stenosis. It is increasingly being used for younger, lower-risk patients, so it is important to ensure the durability for long-term transcatheter aortic valves. The lack of standard definitions of structural valve degeneration (SVD) had made comparison among studies on prosthetic valve durability problematic. The 2017 standardised definitions of SVD by the European Association of Percutaneous Cardiovascular Intervention), the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery, and the 2018 definitions by the Valve In Valve International Data group, has generated an increased uniformity in evaluations. This article examines the potential mechanisms and rates of SVD of transcatheter bioprostheses and the role of redo TAVI as a treatment option.

scholarly journals A Glimpse into the Future: In 2020, Which Patients will Undergo TAVI or SAVR?

2017 ◽  
Vol 12 (01) ◽  
pp. 44 ◽  
Author(s):  
Crochan J O’sullivan ◽  
Peter Wenaweser ◽  
◽  
◽  
Keyword(s):  
Aortic Valve ◽  
Heart Valves ◽  
Severe Aortic Stenosis ◽  
Vascular Complications ◽  
Surgical Aortic Valve Replacement ◽  
Operator Experience ◽  
First Line Therapy ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Valve Implantation

Transcatheter aortic valve implantation (TAVI) has evolved into a safe and effective procedure to treat symptomatic patients with severe aortic stenosis (AS), with predictable and reproducible results. Rates of important complications such as vascular complications, strokes and paravalvular leaks are lower than ever, because of improved patient selection, systematic use of multidector computer tomography, increasing operator experience and device iteration. Accumulating data suggest that transfemoral TAVI with newer generation transcatheter heart valves and delivery systems is superior to conventional surgical aortic valve replacement among intermediate- and high-risk patients with severe symptomatic AS with regard to all-cause mortality and stroke. One can anticipate that by 2020, the majority of patients with severe symptomatic AS will undergo TAVI as first line therapy, regardless of surgical risk.

scholarly journals Transcatheter aortic valve implantation versus surgical aortic valve replacement in low-risk patients: a propensity score-matched analysis

2019 ◽  
Vol 56 (6) ◽  
pp. 1131-1139 ◽  
Author(s):  
Andreas Schaefer ◽  
Niklas Schofer ◽  
Alina Goßling ◽  
Moritz Seiffert ◽  
Johannes Schirmer ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Low Risk ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract OBJECTIVES The aim of the study was to determine the differences in outcomes of surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) in low-risk patients. METHODS All patients with a logistic EuroSCORE II <4% who underwent transfemoral TAVI between 2008 and 2016 (n = 955) or SAVR between 2009 and 2014 (n = 886) at our centre were included. One hundred and nine patients per group were available for propensity score matching. RESULTS Mortality during the 30-day follow-up showed no differences (SAVR vs TAVI: 1.1% vs 1.8%, P = 1.0) but the rates of permanent pacemaker implantation (0.0 vs 14.8%, P < 0.001) and paravalvular leakage ≥ moderate (0.0 vs 7.0%, P = 0.017) were higher in TAVI patients. No difference was found regarding postoperative effective orifice area and transvalvular pressure gradients. Although, the 1-year survival was similar between both groups; 3- and 5-year survival was significantly inferior in the TAVI patient cohort. CONCLUSIONS TAVI yielded similar short-term outcomes compared with SAVR despite higher rates of permanent pacemaker implantation and paravalvular leakage ≥ moderate, but inferior long-term survival. Poorer long-term outcomes of the TAVI patient cohort were attributable to a more comorbid TAVI population. This emphasizes the need for long-term results from randomized controlled trials before TAVI can be broadly expanded to younger low-risk patients.

Transcatheter Valve Implantation for Patients with Aortic Stenosis

2009 ◽  
Vol 4 (1) ◽  
pp. 34
Author(s):  
Grégory Ducrocq ◽  
Dominique Himbert ◽  
Eric Brochet ◽  
Alec Vahanian ◽  
◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Stenosis ◽  
Lower Risk ◽  
Risk Groups ◽  
Careful Evaluation ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Transcatheter Valve ◽  
Valve Implantation

Seven years after the first-in-man transcatheter aortic valve implantation (TAVI) for the treatment of aortic stenosis, it remains a dynamic field of research and development. Evidence from 8,000 patients treated worldwide suggests that TAVI is feasible and provides haemodynamic and clinical improvement for up to three years in patients at high risk or with contraindications to surgery. Pending questions mainly concern safety and long-term durability. Today these techniques are targeted at high-risk patients, but they may be extended to lower-risk groups in the future if their initial promise holds true after careful evaluation.

Energy Loss for Evaluating Transcatheter Valve Performance

2010 ◽  
Author(s):  
Ali N. Azadani
Keyword(s):  
Clinical Impact ◽  
Surgical Risk ◽  
Transcatheter Aortic Valve ◽  
Early Experiences ◽  
High Surgical Risk ◽  
Risk Patients ◽  
Aortic Valve Implantation ◽  
Transcatheter Valve ◽  
Valve Implantation

Transcatheter aortic valve implantation (TAVI) has emerged as a new intervention for high surgical risk patients with severe symptomatic aortic stenosis [1]. The outcomes of the early experiences have been promising and the treatment modality is evolving very rapidly. However, mild to moderate paravalvular leaks occur commonly, over 50% of the time, after TAVI. While mild to moderate aortic regurgitation after TAVI may not have significant clinical impact in high surgical risk elderly patients, this degree of regurgitation may have considerable consequences long-term if TAV are implanted in younger and healthier patients.

scholarly journals Recent advances in understanding and managing aortic stenosis

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 58 ◽  
Author(s):  
Mathias Van Hemelrijck ◽  
Maurizio Taramasso ◽  
Carlotta De Carlo ◽  
Shingo Kuwata ◽  
Evelyn Regar ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Safe Procedure ◽  
Natural Consequence ◽  
Invasive Approach ◽  
Transcatheter Aortic Valve ◽  
Treatment Indications ◽  
Less Invasive Approach ◽  
Risk Patients ◽  
Valve Implantation

Over the last few years, treatment of severe symptomatic aortic stenosis in high-risk patients has drastically changed to adopt a less-invasive approach. Transcatheter aortic valve implantation (TAVI) has been developed as a very reproducible and safe procedure, as shown in many trials. When compared to surgery, TAVI has produced superior, or at least comparable, results, and thus a trend to broaden treatment indications to lower-risk patients has erupted as a natural consequence, even though there is a lack of long-term evidence. In this review, we summarize and underline aspects that still remain unanswered that are compulsory if we want to enhance our understanding of this disease.

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