New devices for TAVI: technologies and initial clinical experiences.
Treatment of aortic stenosis in high-risk surgical patients has been modified in the past 10 years owing to the introduction of transcatheter aortic valve implantation (TAVI). Several issues affecting outcomes with implantation of the first-generation TAVI devices remain unresolved, including haemorrhagic and vascular complications, neurological events, rhythm disturbances, and paravalvular leakage. Further technological improvements are, therefore, required before the indications for TAVI can be extended to young and low-risk patients with aortic stenosis. Many new-generation TAVI devices are currently in the early stages of clinical evaluation. Modifications in the new devices include the ability to reposition the valve before final deployment, features to reduce paravalvular leakage, and the introduction of low-profile delivery systems. The aim of this Review is to provide an overview of the new-generation transcatheter valvular technologies, including initial clinical reports.
Cardiothoracic Department, San Raffaele University Hospital, Via Olgettina 60, 20122 Milan, Italy.
Maurizio
M
Taramasso
Cardiothoracic Department, San Raffaele University Hospital, Via Olgettina 60, 20122 Milan, Italy.
Alberto
A
Pozzoli
Cardiothoracic Department, San Raffaele University Hospital, Via Olgettina 60, 20122 Milan, Italy.
Azeem
A
Latib
Cardiothoracic Department, San Raffaele University Hospital, Via Olgettina 60, 20122 Milan, Italy.
Giovanni
G
La Canna
Cardiothoracic Department, San Raffaele University Hospital, Via Olgettina 60, 20122 Milan, Italy.
Antonio
A
Colombo
Cardiac Surgery Department, University Hospital of Zurich, Rämistrasse 100, 8006 Zurich, Switzerland.
Francesco
F
Maisano
Cardiothoracic Department, San Raffaele University Hospital, Via Olgettina 60, 20122 Milan, Italy.
Ottavio
O
Alfieri
D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization; D004867:Equipment Design; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006801:Humans