INVASIVE INTERVENTIONS IN STRUCTURAL HEART DISEASES: COMPREHENSIVE TECHNIQUES

Invasive Interventions in Structural Heart Diseases-kapak

SELF-EXPANDABLE TRANSCATHETER AORTIC VALVE REPLACEMENT

Aykut Demirkıran

Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Cardiology, Tekirdağ, Türkiye

Demirkıran A. Self-Expandable Transcatheter Aortic Valve Replacement. In: Tanık VO, Özlek B, editors. Invasive Interventions in Structural Heart Diseases: Comprehensive Techniques. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.229-242.

ABSTRACT

Transcatheter aortic valve replacement indications according to the recent randomized prospective studies have been extended worldwide to include younger and lower surgically risk patients. Current transcatheter aortic valve replacement devices still have shortcomings, including paravalvular regurgitation, orifice areas that may limit future treatment procedures, the requirement for permanent pacemaker implantation, and unpredictable coronary access due to commissural misalignment. The use of a balloon-expandable aortic valve was associated with a lower risk of stroke, paravalvular leak, and permanent pacemaker implantation. However, self-expandable valves have been found to have a more reasonable patient-prosthesis mismatch, a lower mean gradient, and a larger effective orifice area. Ongoing randomized controlled trials will definitively demonstrate the customized approaches to valve platform selection in specific clinical scenarios and anatomies..

Keywords: Transcatheter aortic valve replacement; Aortic valve disease; Self-expandable valves

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