INVASIVE INTERVENTIONS IN STRUCTURAL HEART DISEASES: COMPREHENSIVE TECHNIQUES

Invasive Interventions in Structural Heart Diseases-kapak

BALLOON EXPANDABLE TRANSCATHETER AORTIC VALVE IMPLANTATION

Muhammet Salih Ateş1
Alp Yıldırım2

1Ahi Evran University, Faculty of Medicine, Department of Cardiology, Kırşehir, Türkiye
2Ahi Evran University, Faculty of Medicine, Department of Cardiology, Kırşehir, Türkiye

Ateş MS, Yıldırım A. Balloon Expandable Transcatheter Aortic Valve Implantation. In: Tanık VO, Özlek B, editors. Invasive Interventions in Structural Heart Diseases: Comprehensive Techniques. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.215-228.

ABSTRACT

Aortic stenosis is the most prevalent valvular heart disease in adults, with a high incidence in the aging population. Balloon-expandable transcatheter aortic valve implantation (TAVI) has emerged as an effective alternative to surgical aortic valve replacement, especially in patients at high or prohibitive surgical risk. Balloon-expandable TAVI valves are preferred in cases with severe leaflet calcification, small annuli, valve-in-valve procedures, horizontal aorta, and patients at high risk of conduction disturbances. Their key advantages include higher radial force for better expansion, more precise deployment, superior performance in ViV cases, and a lower risk of pacemaker implantation. These systems rely on bioprosthetic valves mounted on metal stents, which are deployed via balloon expansion at the aortic annulus. Technological advancements, including the Edwards SAPIEN series and the newer Myval valves, have improved implantation accuracy, reduced complication rates, and enhanced patient outcomes. Balloon-expandable valves are particularly beneficial for patients with complex anatomical challenges, offering optimal sealing and reducing the risk of paravalvular leaks. Recent trials, such as PARTNER 3 and LANDMARK, have demonstrated the safety and efficacy of these devices in intermediateand low-risk populations, exhibiting durable results and fewer complications. Despite advances, complications such as vascular injuries, conduction disturbances, and acute kidney injury persist, emphasizing the importance of careful patient selection and procedural planning. Future studies should refine TAVI technologies and evaluate long-term outcomes in a broader patient population.

Keywords: Aortic valve stenosis; Transcatheter aortic valve implantation; Aortic valve disease; Balloon valvuloplasty

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