Academic Journal
TAVR as an Alternative to SAVR for Pure Native Aortic Regurgitation
| Τίτλος: | TAVR as an Alternative to SAVR for Pure Native Aortic Regurgitation |
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| Συγγραφείς: | Noble, Stéphane Laurent, Mauler-Wittwer, Sarah |
| Πηγή: | Canadian Journal of Cardiology. 40:316-325 |
| Στοιχεία εκδότη: | Elsevier BV, 2024. |
| Έτος έκδοσης: | 2024 |
| Θεματικοί όροι: | Aortic Valve Insufficiency / surgery, Heart Valve Prosthesis Implantation, Heart Valve Prosthesis Implantation / methods, Aortic Valve Insufficiency, Aortic Valve Insufficiency / diagnosis, Aortic Valve Stenosis, Aortic Valve Stenosis / surgery, 3. Good health, Aortic Valve Insufficiency / etiology, Transcatheter Aortic Valve Replacement, Aortic Valve / surgery, Treatment Outcome, Risk Factors, Aortic Valve, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement / methods, Humans, Aortic Valve Stenosis / diagnosis, Aged |
| Περιγραφή: | Although transcatheter aortic valve replacement was originally fulfilling an unmet clinical need in the elderly population suffering from tricuspid aortic valve stenosis, its use has been progressively expanded to other groups of patients. In this review, we focus on pure native aortic valve regurgitation, which is in most cases a degenerative disease and therefore frequently diagnosed in elderly patients with comorbidities. Symptoms tend to appear late in the disease, when left ventricular dilation and systolic dysfunction are associated owing to excessive volume overload. It is often combined with a dilated aortic annulus and ascending aorta. Surgical aortic valve replacement remains the criterion standard treatment for severe aortic regurgitation. However, for patients at prohibitive surgical risk, transcatheter aortic valve replacement represents an attractive alternative. Various technical challenges are the absence of calcium at the level of the annulus, which means there are no anchoring points or fluoroscopic landmarks, the difficulty of valve sizing, and the increased stroke volume secondary to the aortic regurgitation, making valve deployment more unstable than in the setting of aortic stenosis. The first-generation transcatheter valves were associated with a higher mortality rate and lower procedural success related to increased risk of paravalvular leak and valve migration requiring a second valve or annular rupture than the more recent off-label or on-label transcatheter valves. Early studies with the dedicated on-label devices showed safety and promising results and will undoubtedly serve in the future a growing number of patients with native aortic regurgitation at prohibitive risk for surgery. |
| Τύπος εγγράφου: | Article |
| Περιγραφή αρχείου: | application/pdf |
| Γλώσσα: | English |
| ISSN: | 0828-282X |
| DOI: | 10.1016/j.cjca.2023.11.023 |
| Σύνδεσμος πρόσβασης: | https://pubmed.ncbi.nlm.nih.gov/38016541 https://archive-ouverte.unige.ch/unige:184996 https://doi.org/10.1016/j.cjca.2023.11.023 |
| Rights: | CC BY |
| Αριθμός Καταχώρησης: | edsair.doi.dedup.....063b4f07ac28f2e0000575d80ea3aa8b |
| Βάση Δεδομένων: | OpenAIRE |
| ISSN: | 0828282X |
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| DOI: | 10.1016/j.cjca.2023.11.023 |