Transcatheter aortic valve replacement information
Technique for implantation of the aortic valve in a heart
For Territorial Army Volunteer Reserve (TAVR), see Army Reserve (United Kingdom).
Transcatheter aortic valve replacement
Interventional Cardiologist positioning a TAVI device in patient.
Specialty
Interventional cardiology
Complications
Stroke risk is 4-5% higher in the high-risk patients compared to SAVR[1]
Outcomes
Successful rate: 92%.[1]
[edit on Wikidata]
Transcatheter aortic valve implantation (TAVI) is the implantation of the aortic valve of the heart through the blood vessels without actual removal of the native valve (as opposed to the aortic valve replacement by open heart surgery, surgical aortic valve replacement, AVR). The first TAVI was performed on 16 April 2002 by Alain Cribier, which became a new alternative in the management of high-risk patients with severe aortic stenosis.[2][3] The implantated valve is delivered via one of several access methods: transfemoral (in the upper leg), transapical (through the wall of the heart), subclavian (beneath the collar bone), direct aortic (through a minimally invasive surgical incision into the aorta), and transcaval (from a temporary hole in the aorta near the navel through a vein in the upper leg), among others.
Severe symptomatic aortic stenosis carries a poor prognosis. At present, there is no treatment via medication, making the timing of aortic valve replacement the most important decision to make for these patients.[4] Until recently, surgical aortic valve replacement was the standard treatment for adults with severe symptomatic aortic stenosis. However, the risks associated with surgical aortic valve replacement are increased in elderly patients and those with concomitant severe systolic heart failure or coronary artery disease, as well as in people with comorbidities such as cerebrovascular and peripheral arterial disease, chronic kidney disease, and chronic respiratory dysfunction.
^ abRajput, FA; Zeltser, R (2020), "article-31500", Aortic Valve Replacement, Treasure Island (FL): StatPearls Publishing, PMID 30725821, retrieved 29 March 2020
^Cribier, A; Eltchaninoff, H; Bash, A; Borenstein, N; Tron, C; Bauer, F; Derumeaux, G; Anselme, F; Laborde, F; Leon, MB (10 December 2002). "Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description". Circulation. 106 (24): 3006–8. doi:10.1161/01.cir.0000047200.36165.b8. PMID 12473543.
^Figulla, HR; Franz, M; Lauten, A (March 2020). "The History of Transcatheter Aortic Valve Implantation (TAVI)-A Personal View Over 25 Years of development". Cardiovascular Revascularization Medicine: Including Molecular Interventions. 21 (3): 398–403. doi:10.1016/j.carrev.2019.05.024. PMID 31383557.
^Otto, Catherine M.; Prendergast, Bernard (21 August 2014). "Aortic-Valve Stenosis — From Patients at Risk to Severe Valve Obstruction". New England Journal of Medicine. 371 (8): 744–756. doi:10.1056/NEJMra1313875. PMID 25140960.
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