Transcatheter Aortic Valve Replacement: Current Technology and Future Directions

Abstract

<jats:p> Transcatheter aortic valve replacement as an alternative to open surgical repair is rapidly becoming more used in high-risk patients with aortic stenosis. Transcatheter aortic valve replacement offers the benefit of being much less invasive than traditional surgical repair and has evolved as a therapeutic option for patients with prohibitive surgical risk or those deemed surgically inoperable. Nevertheless, despite its potential to mitigate risk in this frail population, it comes with its own unique set of complications. Technological advancements in valve structure, function, and delivery have and continue to attempt to minimize these risks. This review aims to summarize current advancements in transcatheter aortic valve replacement technology while also introducing areas of future direction in this exciting new field. </jats:p>

Cardiac surgery in the morbidly obese

“…Due to the risk associated with open surgery in patients with multiple comorbidities, including obesity, endovascular techniques have been devised, such as transcatheter aortic valve replacement (TAVI). Such techniques are attractive in that they avoid the need for a cardiopulmonary bypass, require small skin incisions, and may lead to a less proinflammatory state 63 . When comparing the transcatheter approach versus an open approach for aortic valve replacement in 244 obese patients with matched comorbidities, Mariscalco et al demonstrated that 30‐day mortality was similar between the two groups (4.6% vs. 3.3%; p = .56), highlighting that endovascular techniques are a viable alternative in selected cases.…”

“…Such techniques are attractive in that they avoid the need for a cardiopulmonary bypass, require small skin incisions, and may lead to a less proinflammatory state. 63 When comparing the transcatheter approach versus an open approach for aortic valve replacement in 244 obese patients with matched comorbidities, Mariscalco et al…”