title: Transcatheter heart valves for the treatment of aortic stenosis: state-of-the-art.
abstract: Degenerative aortic stenosis is the most frequent heart valve disease. As an alternative to surgical aortic valve replacement, several companies are working on the development of new prosthesis designed to be deployed by transcatheter approaches. Both transfemoral and transapical techniques are feasible, and initial trials in high-risk patients show good procedural outcomes and mid-term (up to 2 years) functionality. Two first-generation prosthesis (Edwards-SAPIEN and CoreValve Revalving System) are commercially available in Europe, and a number of other second-generation valves (with the capabilities of repositioning and retrievability) are under evaluation. Among them, the Sadra-Lotus Valve, The Direct Flow Medical valve and the Paniagua Heart Valve have published first-in-man results; the JenaValve and AorTx devices have also been temporarily implanted in humans. The development of repositionable and retrievable prosthesis with improved profile is mandatory, and it is the main focus of current projects. Not only technical improvements but also operators specialization and an optimal patient selection are essential to improve these initial
  
  
  RESULTS
  Some procedural challenges need to be overcome prior to the expansion of these techniques to lower risk groups, and time is needed for detailed long-term outcomes and risk estimations. Only with a close collaboration among different specialists, basic researchers and the industry will the future development of transcatheter aortic implantation techniques be ensured.
authors.affiliation: Department of Cardiac and Vascular Interventional Services, Lenox Hill Heart and Vascular Institute of New York, New York, NY 10021, USA.
authors.forename: R
authors.initials: R
authors.lastname: Del Valle-Fernández
authors.forename: C E
authors.initials: CE
authors.lastname: Ruiz
mesh_terms: D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D011474:Prosthesis Design