Transcatheter aortic valve implantation

2. Aortic valve replacement
Refused for Surgery
Euro Heart Survey on Valvular Heart Disease (5001 Patients)
32 % did not undergo surgery !
Iung B. and al, Eur. Heart Journal 2003 : 24, 1231-1243
But cardiologists never lose the hope
Interventional Cardiology „Credo‟
“Anything a cardiac
surgeon can do,
an interventional cardiologist can
do
as well or better percutaneously”
AH Gershlick, 2003

3. First human implantation: Alain Cribier
April 16, 2002 ( France)
Bovine pericardium valve
23mm in diameter

8. • Vascular access
– Sites
• Transfemoral
• Transapical
–
–
–
–
Left ant. thoracotomy
More direct, shorter catheter
Septal hypertrophy
Ascendra2, Sapien valve
• Transaortic
–
–
–
–
–
Upper partial sternotomy
Mini-sternotomy 2/3 RICS
Aorta 5 cm above valve
Less painful, familiar approach
Manipulation of ascending aorta
• Subclavian
Percutaneous
or Cut-down
technique

11. “Feasibility trial” reports deployment of new device for
TAVI in aortic insufficiency
23 May 2013, Paris, France: A new investigational device - the
Helio System (TF-FA) - being developed for use with the Sapien
XT Transcatheter Heart Valve was successfully deployed in all
four patients in a small, first-in-human feasibility study of its use
in high-risk aortic insufficiency reported at EuroPCR 2013. there
were no in-hospital deaths. One patient had a stroke/TIA and one
suffered minor vascular complication. One patient, who had preexisting renal impairment, had an acute kidney injury. The
primary endpoint of freedom from all-cause mortality at 30 days
was 100% all four patients were alive at one year. Aortic
insufficiency improved from moderate to severe before the
procedure to trivial at 30 days. Two patients followed up at 12
months had no aortic insufficiency at this time point.