First report on a human percutaneous transluminal implantation of a self-expanding valve prosthesis for interventional treatment of aortic valve stenosis

Abstract

This case report demonstrates a successful percutaneous implantation of a self-expanding aortic valve prosthesis with remarkable functional and clinical improvements in the acute and short-term outcome.

Racional e desenho do registro brasileiro de implante de bioprótese aórtica por cateter

“…Em 2002, Cribier et al 5 realizaram, com sucesso, o primeiro implante percutâneo de uma biopró-tese valvular aórtica em seres humanos, dando início a uma nova era na cardiologia intervencionista. Em 2004, Grube et al 6 implantaram a primeira prótese valvular aórtica CoreValve TM (CoreValve ReValving System, Medtronic, Inc., Minneapolis, Estados Unidos). Atualmente cerca de 25 mil pacientes já foram tratados com esse dispositivo no mundo e a experiência acumulada com o emprego dessas biopróteses em pacientes com contraindicação ou com alto risco cirúrgico indica que os resultados são bastante promissores.…”

Trends in Degenerative Aortic Disease: Novel Alternative Therapies for the Treatment of Severe Aortic Stenosis

“…Of course, not only the experience acquirement but the technical advances in the device design have contributed to this results improvement (Webb JG et al, 2007). In the same line, Grube el al demonstrated a 73% reduction in 30-days mortality (from 40% to 10,8%) in 102 patients who underwent 18F CoreValve system valve implantation in comparison with an older sample treated with the first generation 25F device (Grube E et al ., 2005). This data suggest that, while improvements in the design of the device and the selection of patients keep on growing exponentially, a reduction in the learning curve requirements should be expected for the next generation of devices and future centre incorporations to this alternative technique.…”

“…There are several devices commercialized, the most used are the Medtronic CoreValve® Transcatheter Aortic Valve Implantation System (Medtronic Inc, Minneapolis, USA) and the Edwards Sapien® Trancatheter Heart Valve system (Edwards Lifesciences Inc., Irvine, USA). CoreValve first implantation was reported for Grube et al in 2005 and obtained the CE mark in 2007. More than 10.000 devices have been already successfully implanted in more than 34 countries, and recently a clinical trial has been approved by the Food and Drugs Administration to evaluate its results in the USA.…”

Multislice computer tomography (MSCT) for the optimisation of transcatheter aortic valve implantation (TAVI)

“…The design and deployment features have been extensively described. (4,5,20) Potential candidates for TAVI are screened based on anatomical eligibility guidelines, which are device-specific due to the differences in the design and geometry between the MCS and ESD (Figure 1). …”

“…In the majority of procedures where patients received a TAVI prosthesis thus far contrast angiography (CA) and 2-D echocardiography -either transthoracic (TTE) or transoesophageal (TEE) -were used to execute all these steps. (4,5) However, the Summer 2012 Volume 9 • Number 1 Interestingly the majority of studies that examined the diagnostic accuracy of MSCT planimetry for the diagnosis of severe aortic stenosis used as comparator TTE AVA based on the continuity equation. (11) This can be viewed as a limitation given that the gold standard for the diagnosis of aortic stenosis in patients with preserved left ventricular function is peak transvalvular flow velocity from TTE.…”