Technical Aspects and Development of Transcatheter Aortic Valve Implantation
Aortic stenosis is the most common valve disease requiring surgery or percutaneous treatment. Since the first-in-man implantation in 2002 we have witnessed incredible progress in transcatheter aortic valve implantation (TAVI). In this article, we review the technical aspects of TAVI development with...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-08-01
|
| Series: | Journal of Cardiovascular Development and Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3425/9/8/282 |
| _version_ | 1797444545049264128 |
|---|---|
| author | Klemen Steblovnik Matjaz Bunc |
| author_facet | Klemen Steblovnik Matjaz Bunc |
| author_sort | Klemen Steblovnik |
| collection | DOAJ |
| description | Aortic stenosis is the most common valve disease requiring surgery or percutaneous treatment. Since the first-in-man implantation in 2002 we have witnessed incredible progress in transcatheter aortic valve implantation (TAVI). In this article, we review the technical aspects of TAVI development with a look at the future. Durability, low thrombogenicity, good hydrodynamics, biocompatibility, low catheter profile, and deployment stability are the attributes of an ideal TAVI device. Two main design types exist—balloon-expandable and self-expanding prostheses. Balloon-expandable prostheses use a cobalt-chromium alloy frame providing high radial strength and radiopacity, while the self-expanding prostheses use a nickel-titanium (Nitinol) alloy frame, which expands to its original shape once unsheathed and heated to the body temperature. The valve is sewn onto the frame and consists of the porcine or bovine pericardium, which is specially treated to prevent calcinations and prolong durability. The lower part of the frame can be covered by polyethylene terephthalate fabric or a pericardial skirt, providing better sealing between the frame and aortic annulus. The main future challenges lie in achieving lower rates of paravalvular leaks and new pacemaker implantations following the procedure, lower delivery system profiles, more precise positioning, longer durability, and a good hemodynamic profile. Patient-specific design and the use of autologous tissue might solve these issues. |
| first_indexed | 2024-03-09T13:13:08Z |
| format | Article |
| id | doaj.art-fc20832eea27477a8766cf6869dadc87 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T13:13:08Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-fc20832eea27477a8766cf6869dadc872023-11-30T21:40:07ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-08-019828210.3390/jcdd9080282Technical Aspects and Development of Transcatheter Aortic Valve ImplantationKlemen Steblovnik0Matjaz Bunc1Department of Cardiology, University Medical Centre Ljubljana, 1000 Ljubljana, SloveniaDepartment of Cardiology, University Medical Centre Ljubljana, 1000 Ljubljana, SloveniaAortic stenosis is the most common valve disease requiring surgery or percutaneous treatment. Since the first-in-man implantation in 2002 we have witnessed incredible progress in transcatheter aortic valve implantation (TAVI). In this article, we review the technical aspects of TAVI development with a look at the future. Durability, low thrombogenicity, good hydrodynamics, biocompatibility, low catheter profile, and deployment stability are the attributes of an ideal TAVI device. Two main design types exist—balloon-expandable and self-expanding prostheses. Balloon-expandable prostheses use a cobalt-chromium alloy frame providing high radial strength and radiopacity, while the self-expanding prostheses use a nickel-titanium (Nitinol) alloy frame, which expands to its original shape once unsheathed and heated to the body temperature. The valve is sewn onto the frame and consists of the porcine or bovine pericardium, which is specially treated to prevent calcinations and prolong durability. The lower part of the frame can be covered by polyethylene terephthalate fabric or a pericardial skirt, providing better sealing between the frame and aortic annulus. The main future challenges lie in achieving lower rates of paravalvular leaks and new pacemaker implantations following the procedure, lower delivery system profiles, more precise positioning, longer durability, and a good hemodynamic profile. Patient-specific design and the use of autologous tissue might solve these issues.https://www.mdpi.com/2308-3425/9/8/282aortic stenosisTAVImaterialstechnology |
| spellingShingle | Klemen Steblovnik Matjaz Bunc Technical Aspects and Development of Transcatheter Aortic Valve Implantation Journal of Cardiovascular Development and Disease aortic stenosis TAVI materials technology |
| title | Technical Aspects and Development of Transcatheter Aortic Valve Implantation |
| title_full | Technical Aspects and Development of Transcatheter Aortic Valve Implantation |
| title_fullStr | Technical Aspects and Development of Transcatheter Aortic Valve Implantation |
| title_full_unstemmed | Technical Aspects and Development of Transcatheter Aortic Valve Implantation |
| title_short | Technical Aspects and Development of Transcatheter Aortic Valve Implantation |
| title_sort | technical aspects and development of transcatheter aortic valve implantation |
| topic | aortic stenosis TAVI materials technology |
| url | https://www.mdpi.com/2308-3425/9/8/282 |
| work_keys_str_mv | AT klemensteblovnik technicalaspectsanddevelopmentoftranscatheteraorticvalveimplantation AT matjazbunc technicalaspectsanddevelopmentoftranscatheteraorticvalveimplantation |