title: Second-generation transapical valves: the Medtronic Engager system.
abstract: The Medtronic Engager aortic valve system is a second-generation transcatheter aortic valve implantation bioprosthesis combined with a delivery system designed for over-the-wire transapical implantation of the valve. The self-expandable stent has control arms to be placed into the native aortic sinuses to achieve correct positioning of the bioprosthesis in a predefined height. The purpose of the lower skirt is to reduce paravalvular leakage. A three-leaflet, bovine pericardium valve is mounted on the stent. The implantation is facilitated by the control arms and rotational positioning of the commissural posts. A multicentre feasibility study showed promising results. The results from the following European pivotal trial led to CE mark approval in 2013. Here, we describe technical details of the device and its implantation technique and highlight special steps of the procedure.
authors.affiliation: Division of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Simon H
authors.initials: SH
authors.lastname: Sündermann
authors.forename: David
authors.initials: D
authors.lastname: Holzhey
authors.forename: Sabine
authors.initials: S
authors.lastname: Bleiziffer
authors.forename: Hendrik
authors.initials: H
authors.lastname: Treede
authors.forename: Stephan
authors.initials: S
authors.lastname: Jacobs
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
mesh_terms: D000792:Angiography / Q000379:methods; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000379:methods; D006350:Heart Valve Prosthesis; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology*; D017755:Prosthesis Fitting / Q000379:methods; D012720:Severity of Illness Index; D015607:Stents; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
keywords: Aortic valve disease; Second-generation devices; Transapical; Transcatheter aortic valve implantation