This Article Figures Only Full Text Full Text (PDF) View Related Genuine Article on CVN View Related Cardiosource Journal Scan Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Webb, J. G. Articles by Boone, R. A. Search for Related Content PubMed PubMed Citation Articles by Webb, J. G. Articles by Boone, R. A. Related Collections Related Article

FOCUS ISSUE: VALVULAR HEART DISEASE: CLINICAL RESEARCH

A New Transcatheter Aortic Valve and Percutaneous Valve Delivery System

Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada

Manuscript received April 29, 2008; revised manuscript received July 15, 2008, accepted July 21, 2008.

^_* Reprint requests and correspondence: Dr. John G. Webb, McLeod Professor of Heart Valve Intervention, St. Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia, Canada V6Z 1Y6 (Email: webb{at}providencehealth.bc.ca).

Objectives: We describe procedural and clinical outcomes in a high-risk cohort undergoing transcatheter aortic valve replacement with early next-generation transcatheter valve and delivery systems.

Background: Percutaneous aortic valve replacement is gaining acceptance as a viable option in patients at high surgical risk. Broader application will require further advances in valve and delivery system technology.

Methods: Transarterial aortic valve replacement was attempted in 25 patients (mean age 85 years) determined to be at high surgical risk due to comorbidities. A new delivery catheter system (RetroFlex 2, Edwards Lifesciences, Irving, California) was utilized in combination with either a balloon-expandable SAPIEN (Edwards Lifesciences) valve or a next-generation low-profile cobalt-chromium bovine pericardial SAPIEN XT (Edwards Lifesciences) valve.

Results: Percutaneous valve replacement was successful in all 25 high-risk patients. Aortic valve area increased from 0.59 ± 0.15 cm² to 1.60 ± 0.27 cm². In this high-risk cohort (Society of Thoracic Surgeons and logistic EuroSCORE estimates of surgical mortality were 8.9% and 21.0%, respectively), 30-day mortality was 0%.

Conclusions: Technical and procedural advances in catheter systems and prosthetic valves designed for percutaneous aortic valve delivery may contribute to increased procedural success and improved clinical outcomes.

Key Words: aortic stenosis • percutaneous • valve • valvuloplasty

Abbreviations and Acronyms   AVR = aortic valve replacement   IQR = interquartile range

Related Article

Inside This Issue
J. Am. Coll. Cardiol. 2009 53: A28. [Full Text] [PDF]

This article has been cited by other articles:

				R. Gurvitch, A. Cheung, J. Ye, D. A. Wood, A. B. Willson, S. Toggweiler, R. Binder, and J. G. Webb Transcatheter Valve-in-Valve Implantation for Failed Surgical Bioprosthetic Valves. J. Am. Coll. Cardiol., November 15, 2011; 58(21): 2196 - 2209. [Abstract] [Full Text] [PDF]

				A. C. T. Ng, K.-H. Yiu, S. H. Ewe, F. van der Kley, M. Bertini, A. de Weger, A. de Roos, D. Y. Leung, J. D. Schuijf, M. J. Schalij, et al. Influence of left ventricular geometry and function on aortic annular dimensions as assessed with multi-detector row computed tomography: implications for transcatheter aortic valve implantation Eur. Heart J., November 2, 2011; 32(22): 2806 - 2813. [Abstract] [Full Text] [PDF]

				R. Gurvitch, J. G. Webb, R. Yuan, M. Johnson, C. Hague, A. B. Willson, S. Toggweiler, D. A. Wood, J. Ye, R. Moss, et al. Aortic Annulus Diameter Determination by Multidetector Computed Tomography: Reproducibility, Applicability, and Implications for Transcatheter Aortic Valve Implantation J. Am. Coll. Cardiol. Intv., November 1, 2011; 4(11): 1235 - 1245. [Abstract] [Full Text] [PDF]

				J. L. Zamorano, L. P. Badano, C. Bruce, K.-L. Chan, A. Goncalves, R. T. Hahn, M. G. Keane, G. La Canna, M. J. Monaghan, P. Nihoyannopoulos, et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease Eur. Heart J., September 1, 2011; 32(17): 2189 - 2214. [Abstract] [Full Text] [PDF]

				R. Tarricone and M. Drummond Challenges in the clinical and economic evaluation of medical devices: The case of transcatheter aortic valve implantation Journal of Medical Marketing: Device, Diagnostic and Pharmacetical Marketing, August 1, 2011; 11(3): 221 - 229. [Abstract] [PDF]

				J. L. Zamorano, L. P. Badano, C. Bruce, K.-L. Chan, A. Goncalves, R. T. Hahn, M. G. Keane, G. La Canna, M. J. Monaghan, P. Nihoyannopoulos, et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease Eur Heart J Cardiovasc Imaging, August 1, 2011; 12(8): 557 - 584. [Abstract] [Full Text] [PDF]

				E. E. Roselli Engineering Transcatheter Aortic Valve Devices: A Surgeon's Perspective Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, March 1, 2011; 225(3): 207 - 219. [Abstract] [PDF]

				C. Godino, F. Maisano, M. Montorfano, A. Latib, A. Chieffo, I. Michev, R. Al-Lamee, M. Bande, M. Mussardo, F. Arioli, et al. Outcomes After Transcatheter Aortic Valve Implantation With Both Edwards-SAPIEN and CoreValve Devices in a Single Center: The Milan Experience J. Am. Coll. Cardiol. Intv., November 1, 2010; 3(11): 1110 - 1121. [Abstract] [Full Text] [PDF]

				R. Gurvitch, D. A. Wood, E. L. Tay, J. Leipsic, J. Ye, S. V. Lichtenstein, C. R. Thompson, R. G. Carere, N. Wijesinghe, F. Nietlispach, et al. Transcatheter Aortic Valve Implantation: Durability of Clinical and Hemodynamic Outcomes Beyond 3 Years in a Large Patient Cohort Circulation, September 28, 2010; 122(13): 1319 - 1327. [Abstract] [Full Text] [PDF]

				R. R. Coeytaux, J. W. Williams Jr., R. N. Gray, and A. Wang Percutaneous Heart Valve Replacement for Aortic Stenosis: State of the Evidence Ann Intern Med, September 7, 2010; 153(5): 314 - 324. [Abstract] [Full Text] [PDF]

				H. Jilaihawi, R. Bonan, A. Asgar, R. Ibrahim, T. Spyt, D. Chin, and J. Kovac Anatomic Suitability for Present and Next Generation Transcatheter Aortic Valve Prostheses: Evidence for a Complementary Multidevice Approach to Treatment J. Am. Coll. Cardiol. Intv., August 1, 2010; 3(8): 859 - 866. [Abstract] [Full Text] [PDF]

				S. R. Dixon, C. L. Grines, and W. W. O'Neill The Year in Interventional Cardiology J. Am. Coll. Cardiol., May 18, 2010; 55(20): 2272 - 2286. [Full Text] [PDF]

				J. G. Webb and F. Nietlispach Chapter 39 Transcatheter aortic valve replacement Oxford Textbook of Interventional Cardiology, January 1, 2010; 1(1): med-9780199569083-chapter - med-9780199569083-chapter. [Abstract] [Full Text]

				J. G. Webb, L. Altwegg, R. H. Boone, A. Cheung, J. Ye, S. Lichtenstein, M. Lee, J. B. Masson, C. Thompson, R. Moss, et al. Transcatheter Aortic Valve Implantation: Impact on Clinical and Valve-Related Outcomes Circulation, June 16, 2009; 119(23): 3009 - 3016. [Abstract] [Full Text] [PDF]