[Percutaneous heart valves: clinical role].
Percutaneous valve therapy is said to be the last frontier in interventional cardiology. Over the past few years the work of decades has come to fruition. The first percutaneous implantation of a cardiac stent-valve in a human was reported by Bonhoeffer and colleagues in 2000. The first percutaneous aortic valve placement was performed by Cribier in 2002 using an antegrade approach in a patient with critical aortic stenosis. Attempts at percutaneous mitral valve repair are as varied as the pathophysiological mechanisms of mitral regurgitation. We are now embarking on a new era in the treatment of valvular heart disease with the introduction of percutaneous and minimally invasive devices and techniques to address valve dysfunction without conventional surgical repair/replacement. Pathology of all four cardiac valves has now been treated in early stage clinical feasibility (pilot) trials. There are at least 30 percutaneous valve programs currently being developed by 24 different companies. Two of the percutaneous aortic valve devices and five of the mitral valve devices are in various stages of clinical trials, ranging from feasibility to pivotal at the present time. Large-scale trials comparing percutaneous valve replacement and repair with surgery are just beginning. In this article we will look at the various technologies and advances in percutaneous valve replacement and repair, with an emphasis on those devices that are currently being utilized in the clinical realm.
Colombo
Paola
P
Dipartimento di Cardiologia e Cardiochirurgia A. De Gasperis, Ospedale Niguarda Ca' Granda. Milano. paolacolombo@fastwebnet.it
Bruschi
Giuseppe
G
Bossi
Irene
I
Pirola
Roberto
R
Klugmann
Silvio
S
D006348:Cardiac Surgical Procedures / Q000295:instrumentation; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D011474:Prosthesis Design