title: Innovations and novel technologies in TAVI. Second generation transcatheter heart valves.
abstract: Transcatheter aortic valve implantation (TAVI) is the new standard-of-care for inoperable patients with superior outcome compared to conservative management including balloon valvuloplasty. In high-risk patients, TAVI has shown non-inferiority compared with surgical aortic valve replacement. Although data from national multi-centre registries are very encouraging and use of TAVI in intermediate risk patients has been discussed, it is of note that the commercially available and currently used transcatheter heart valves (THV) have not yet been assessed by randomized clinical trials in those patients. New technology advances promise to simplify TAVI and to improve outcome by reducing the rate of TAVI-specific issues such as paravalvular aortic regurgitation (PAR), annular rupture, and conduction disturbances. A reduction in the incidence and severity of PAR represents an obvious target for technical improvements in the design of upcoming "next generation" THVs and of implantation techniques including repositioning/recapturing features, paravalvular sealing techniques, and precise peri-interventional imaging modalities.
authors.affiliation: Herzzentrum Bonn, Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Germany.
authors.forename: J M
authors.initials: JM
authors.lastname: Sinning
authors.forename: N
authors.initials: N
authors.lastname: Werner
authors.forename: M
authors.initials: M
authors.lastname: Vasa-Nicotera
authors.forename: A
authors.initials: A
authors.lastname: Ghanem
authors.forename: C
authors.initials: C
authors.lastname: Hammerstingl
authors.forename: E
authors.initials: E
authors.lastname: Grube
authors.forename: G
authors.initials: G
authors.lastname: Nickenig
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000517:prevention & control / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D001145:Arrhythmias, Cardiac / Q000517:prevention & control; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D006341:Heart Rupture / Q000517:prevention & control; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D015337:Multicenter Studies as Topic; D011183:Postoperative Complications / Q000517:prevention & control; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D035703:Therapies, Investigational