Surgical aortic valve replacement (SAVR) is highly effective and can be achieved with relatively low risk in patients with severe aortic stenosis. Bioprostheses have been used most frequently during the past 60 years. However, the function of biological valves usually declines after 10-15 years from implant when structural valve degeneration occurs often mandating a reoperation once valve dysfunction becomes haemodynamically significant. Known for many years by surgeons and cardiologists taking care of patients with SAVR, the issue of postimplant structural valve degeneration has been recently highlighted also in patients with transcatheter aortic valve implant (TAVI). There is growing concern that TAVI valves exhibit structural valve degeneration due to inherent challenges of the deployment mode. The impact on postimplant degeneration of TAVI valves compared to SAVR has still to be understood and defined. Based on the ongoing process of expanding TAVI indications, several potential shortcomings and caveats, learned during the last 60 years of SAVR experience, should be taken into consideration to refine this technique.

Postimplant biological aortic prosthesis degeneration : challenges in transcatheter valve implants / E. Bidar, T. Folliguet, J. Kluin, C. Muneretto, A. Parolari, F. Barili, P. Suwalski, N. Bonaros, P. Punjabi, R. Sadaba, M. De Bonis, N. Al-Attar, J.F. Obadia, M. Czerny, M. Shrestha, R. Zegdi, E. Natour, R. Lorusso. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 55:2(2019), pp. 191-200.

Postimplant biological aortic prosthesis degeneration : challenges in transcatheter valve implants

A. Parolari;F. Barili;
2019

Abstract

Surgical aortic valve replacement (SAVR) is highly effective and can be achieved with relatively low risk in patients with severe aortic stenosis. Bioprostheses have been used most frequently during the past 60 years. However, the function of biological valves usually declines after 10-15 years from implant when structural valve degeneration occurs often mandating a reoperation once valve dysfunction becomes haemodynamically significant. Known for many years by surgeons and cardiologists taking care of patients with SAVR, the issue of postimplant structural valve degeneration has been recently highlighted also in patients with transcatheter aortic valve implant (TAVI). There is growing concern that TAVI valves exhibit structural valve degeneration due to inherent challenges of the deployment mode. The impact on postimplant degeneration of TAVI valves compared to SAVR has still to be understood and defined. Based on the ongoing process of expanding TAVI indications, several potential shortcomings and caveats, learned during the last 60 years of SAVR experience, should be taken into consideration to refine this technique.
Aortic valve replacement; Structural valve degeneration; Transcatheter aortic valve degeneration; Transcatheter aortic valve implant; Surgery; Pulmonary and Respiratory Medicine; Cardiology and Cardiovascular Medicine
Settore MED/23 - Chirurgia Cardiaca
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/638541
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