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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

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

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