Transcatheter aortic valve implantation (TAVI) has overcome the pioneering phase and thanks to accrued clinical evidence has become a mainstay alternative to surgical aortic valve replacement (SAVR) in patients at high risk for postoperative complications. Despite these successes, TAVI remains a Junior technology facing momentous developments in techniques and devices. Indeed, several new-generation devices for TAVI have become available in the last few years, including Acurate, Allegra, Evolut, Lotus, JenaValve, Portico, and SAPIEN3. Despite the inevitable setbacks, such as the one represented by DirectFlow, these new devices appear associated with comparative benefits, especially for minimal invasiveness, rates of permanent pacemaker implantation, and risk of residual aortic regurgitation. Indeed, no single device appears clearly better than the others, and a tailored and individualized approach should be sought in using these prostheses, taking into account operator and institutional expertise, on top of patient features. Few comparative effectiveness studies are available to date to guide decision making, and thus careful scrutiny is needed even in everyday clinical practice, especially if seeking to expand the current indications of TAVI. Further guidance will however come from long-term follow-up of completed studies and from results of ongoing trials.

New-generation devices for transcatheter aortic valve implantation / Gatto, L.; Biondi-Zoccai, G.; Romagnoli, E.; Frati, G.; Prati, F.; Giordano, A.. - In: MINERVA CARDIOANGIOLOGICA. - ISSN 0026-4725. - 66:6(2018), pp. 747-761. [10.23736/S0026-4725.18.04707-2]

New-generation devices for transcatheter aortic valve implantation

Gatto L.;Biondi-Zoccai G.;Frati G.;
2018

Abstract

Transcatheter aortic valve implantation (TAVI) has overcome the pioneering phase and thanks to accrued clinical evidence has become a mainstay alternative to surgical aortic valve replacement (SAVR) in patients at high risk for postoperative complications. Despite these successes, TAVI remains a Junior technology facing momentous developments in techniques and devices. Indeed, several new-generation devices for TAVI have become available in the last few years, including Acurate, Allegra, Evolut, Lotus, JenaValve, Portico, and SAPIEN3. Despite the inevitable setbacks, such as the one represented by DirectFlow, these new devices appear associated with comparative benefits, especially for minimal invasiveness, rates of permanent pacemaker implantation, and risk of residual aortic regurgitation. Indeed, no single device appears clearly better than the others, and a tailored and individualized approach should be sought in using these prostheses, taking into account operator and institutional expertise, on top of patient features. Few comparative effectiveness studies are available to date to guide decision making, and thus careful scrutiny is needed even in everyday clinical practice, especially if seeking to expand the current indications of TAVI. Further guidance will however come from long-term follow-up of completed studies and from results of ongoing trials.
2018
Aortic valve stenosis; Comparative effectiveness research; Transcatheter aortic valve replacement; Aortic Valve; Aortic Valve Stenosis; Humans; Postoperative Complications; Prosthesis Design; Transcatheter Aortic Valve Replacement; Heart Valve Prosthesis
01 Pubblicazione su rivista::01a Articolo in rivista
New-generation devices for transcatheter aortic valve implantation / Gatto, L.; Biondi-Zoccai, G.; Romagnoli, E.; Frati, G.; Prati, F.; Giordano, A.. - In: MINERVA CARDIOANGIOLOGICA. - ISSN 0026-4725. - 66:6(2018), pp. 747-761. [10.23736/S0026-4725.18.04707-2]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1474290
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