Percutaneous aortic valve replacement (part 2): Miniaturization of the delivery system based on the novel temporary valve technology.
Percutaneous aortic valve replacement remains an investigational procedure challenged by multiple key issues. In part 1 of this 2 part series, the issue of precise placement of the percutaneous aortic valve was addressed by a novel design of a delivery and deployment system. The design and use of a hemodynamics supporting temporary aortic valve was highlighted, which can stabilize the hemodynamic and local flow conditions for a more controlled and precise placement of the percutaneous aortic valve. In this part 2 study, the issue of vascular access complications is addressed. The current large French size catheter systems can cause significant vascular injuries; the catheter diameter must be reduced for this procedure to be safe and routine. The hemodynamic support of the temporary aortic valve system allows for the formulation of a novel approach to reduce the catheter-delivery system. The miniaturization strategies consist of pretreatment of the aortic annulus and assembly of the percutaneous aortic valve apparatus in a piecemeal fashion of smaller components. Each component would, therefore, require a smaller diameter delivery catheter. The combined strategies as described in this 2 part series aim at realizing the percutaneous aortic valve replacement as a routine, fully percutaneous and cath lab-based.
Ho
Paul C
PC
HOCOR Cardiovascular Technologies, LLC, Honolulu, Hawaii, USA. hocor@mac.com
D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006439:Hemodynamics; D006801:Humans; D008904:Miniaturization; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control