title: Endovascular resection of the native aortic valve before transcatheter aortic valve implantation: state of the art and review.
abstract: Transcatheter aortic valve implantation was introduced into clinical practice in 2002 as a rescue approach in patients presenting with symptomatic severe aortic stenosis but not eligible for conventional aortic valve replacement. This technique allows implantation of a balloon expandable bioprosthesis without resection of the native aortic valve. Several complications are described as a consequence of the residual highly calcified valve being squeezed against the aortic wall by the stent of the implant. This can result in deformation of the metal stent and paravalvular leakage, risk of occlusion of the coronary ostia, or central and peripheral embolization of valvular debris. To avoid these complications, many authors suggest the possibility to resect and remove the native aortic valve before transcatheter aortic valve implantation. In this field, different authors have described possible techniques and different sources of energy to resect the calcified valve. In this article, we review the development of these experimental techniques and discuss future prospects in this field.
authors.affiliation: Cardiovascular and Thoracic Surgery Department, Saint-Luc Hospital, Catholic University of Louvain Brussels, Belgium emiliano.navarra@uclouvain.be.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Navarra
authors.affiliation: Cardiovascular and Thoracic Surgery Department, Saint-Luc Hospital, Catholic University of Louvain Brussels, Belgium.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Mosala Nezhad
authors.affiliation: Center for Research in Mechatronics, Catholic University of Louvain, Leuven la Neuve, Belgium.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bollen
authors.affiliation: Cardiovascular and Thoracic Surgery Department, Saint-Luc Hospital, Catholic University of Louvain Brussels, Belgium.
authors.forename: Charles-Edouard
authors.initials: CE
authors.lastname: Gielen
authors.affiliation: Cardiovascular and Thoracic Surgery Department, Saint-Luc Hospital, Catholic University of Louvain Brussels, Belgium.
authors.forename: Stefano
authors.initials: S
authors.lastname: Mastrobuoni
authors.affiliation: Cardiovascular and Thoracic Surgery Department, Saint-Luc Hospital, Catholic University of Louvain Brussels, Belgium.
authors.forename: Laurent
authors.initials: L
authors.lastname: De Kerchove
authors.affiliation: Center for Research in Mechatronics, Catholic University of Louvain, Leuven la Neuve, Belgium.
authors.forename: Benoit
authors.initials: B
authors.lastname: Raucent
authors.affiliation: Cardiovascular and Thoracic Surgery Department, Saint-Luc Hospital, Catholic University of Louvain Brussels, Belgium.
authors.forename: Parla
authors.initials: P
authors.lastname: Astarci
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery; D001705:Bioprosthesis; D004867:Equipment Design; D006350:Heart Valve Prosthesis; D006801:Humans; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*
keywords: Aortic valve resection tools; Endovascular aortic valve resection; Intracardiac aortic valve resection; Transcatheter aortic valve