title: New frontiers in aortic therapy: focus on current trials and devices in transcatheter aortic valve replacement.
abstract: The first decade of clinical experience with transcatheter aortic valve replacement since 2002 saw the development of 2 main valve systems, namely the Edwards Sapien balloon-expandable valve series and the Medtronic self-expanding CoreValve. These 2 valve platforms now have achieved commercial approval and application worldwide in patients with severe aortic stenosis whose perioperative risk for surgical intervention is high or extreme. In the second decade of transcatheter aortic valve replacement, clinical experience and refinements in valve design have resulted in clinical drift towards lower patient risk cohorts. There are currently 2 major trials, PARTNER II and SURTAVI, that are both evaluating the role of transcatheter aortic valve replacement in intermediate-risk patient cohorts. The results from these landmark trials may usher in a new clinical paradigm for transcatheter aortic valve replacement in its second decade.
authors.affiliation: Department of Anesthesiology and Critical Care.
authors.forename: Jacob T
authors.initials: JT
authors.lastname: Gutsche
authors.affiliation: Department of Anesthesiology and Critical Care.
authors.forename: Prakash A
authors.initials: PA
authors.lastname: Patel
authors.affiliation: Department of Surgery.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Walsh
authors.affiliation: Department of Anesthesiology and Critical Care.
authors.forename: Aris
authors.initials: A
authors.lastname: Sophocles
authors.affiliation: Department of Anesthesiology and Critical Care.
authors.forename: Sy-Yeu S
authors.initials: SY
authors.lastname: Chern
authors.affiliation: Department of Surgery.
authors.forename: David B
authors.initials: DB
authors.lastname: Jones
authors.affiliation: Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Saif
authors.initials: S
authors.lastname: Anwaruddin
authors.affiliation: Department of Surgery.
authors.forename: Nimesh D
authors.initials: ND
authors.lastname: Desai
authors.affiliation: Department of Anesthesiology and Critical Care.
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Weiss
authors.affiliation: Department of Anesthesiology and Critical Care. Electronic address: yiandoc@hotmail.com.
authors.forename: John G T
authors.initials: JG
authors.lastname: Augoustides
mesh_terms: D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D002986:Clinical Trials as Topic / Q000379:methods; D006350:Heart Valve Prosthesis / Q000639:trends*; D006801:Humans; D011474:Prosthesis Design / Q000639:trends*; D065467:Transcatheter Aortic Valve Replacement / Q000295:instrumentation / Q000379:methods / Q000639:trends*; D016896:Treatment Outcome
keywords: Kansas City Cardiomyopathy Questionnaire; PARTNER I trial; PARTNER II trial; SURTAVI trial; Sapien 3 valve; Sapien XT valve; Society of Thoracic Surgeons; Valve Academic Research Consortium; balloon-expandable Sapien valve; frailty; quality of life; self-inflating CoreValve; surgical aortic valve replacement; transcatheter aortic valve replacement