Current Balloon-Expandable Transcatheter Heart Valve and Delivery Systems

被引:28
作者
Nietlispach, Fabian [1 ]
Wijesinghe, Namal [1 ]
Wood, David [1 ]
Carere, Ronald G. [1 ]
Webb, John G. [1 ]
机构
[1] St Pauls Hosp, Dept Cardiol, Vancouver, BC V6Z 1Y6, Canada
关键词
transcatheter heart valve; SAPIEN XT; RetroFlex; NovaFlex; CALCIFIC AORTIC-STENOSIS; IMPLANTATION; PROSTHESIS; REPLACEMENT; RETROGRADE; EXPERIENCE;
D O I
10.1002/ccd.22279
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Objectives: Transcatheter valve and valve delivery systems are undergoing rapid evolution. We describe the current generation balloon-expandable valve and delivery systems. Background and Methods: The SAPIEN XT valve represents the newest generation balloon-expandable aortic bioprosthesis. A cobalt-chromium alloy frame and additional design modifications facilitate a reduction in delivery profile while maintaining structural integrity, hemodynamics, and durability. The RetroFlex 3 (TM) delivery system represents the latest clinically available delivery system. It incorporates a fixed, tapered, and deflecting crossing tip to facilitate atraumatic introduction and a rapid inflation lumen to reduce valve motion during deployment. The NovaFlex (TM) delivery system represents the next generation delivery catheter. When used in conjunction with the SAPIEN XT (TM) valve and a specially constructed introducer sheath the inner and the outer diameters are 18 and 21 F, respectively. Results: The RetroFlex 3 delivery system was utilized in nine patients and the NovaFlex delivery system in four. The valve implanted was the SAPIEN in six and the SAPIEN XT valve in seven. Implantation was successful in all patients. A reduction in device movement during balloon deployment was apparent as compared with earlier delivery systems. Aortic mean gradient fell from 45.6 (+/- 15.1) mm Hg to 13.2 (+/- 5.1) mm Hg, valve area rose from 0.68 (+/-.19) to 1.5 (+/- 0.28) cm(2). No patient had more than mild paravalvular regurgitation. Conclusion: Transcatheter valves and delivery systems continue to improve in terms of profile and ease of use. (C) 2009 Wiley-Liss, Inc.
引用
收藏
页码:295 / 300
页数:6
相关论文
共 13 条
[1]
Early experience with percutaneous transcatheter implantation of heart valve prosthesis for the treatment of end-stage inoperable patients with calcific aortic stenosis [J].
Cribier, A ;
Eltchaninoff, H ;
Tron, C ;
Bauer, F ;
Agatiello, C ;
Sebagh, L ;
Bash, A ;
Nusimovici, D ;
Litzler, PY ;
Bessou, JP ;
Leon, MB .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2004, 43 (04) :698-703
[2]
Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis - First human case description [J].
Cribier, A ;
Eltchaninoff, H ;
Bash, A ;
Borenstein, N ;
Tron, C ;
Bauer, F ;
Derumeaux, G ;
Anselme, F ;
Laborde, F ;
Leon, MB .
CIRCULATION, 2002, 106 (24) :3006-3008
[3]
Retrograde Versus Antegrade Percutaneous Aortic Balloon Valvuloplasty: Immediate, Short- and Long-Term Outcome at 2 Years [J].
Cubeddu, Roberto J. ;
Jneid, Hani ;
Don, Creighton W. ;
Witzke, Christian F. ;
Cruz-Gonzalez, Ignacio ;
Gupta, Rakesh ;
Rengifo-Moreno, Pablo ;
Maree, Andrew O. ;
Inglessis, Ignacio ;
Palacios, Igor F. .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2009, 74 (02) :225-231
[4]
Contemporary surgical or percutaneous management of severe aortic stenosis in the elderly [J].
Descoutures, Fleur ;
Himbert, Dominique ;
Lepage, Laurent ;
Iung, Bernard ;
Detaint, Delphine ;
Tchetche, Didier ;
Brochet, Eric ;
Castier, Yves ;
Depoix, Jean-Pol ;
Nataf, Patrick ;
Vahanian, Alec .
EUROPEAN HEART JOURNAL, 2008, 29 (11) :1410-1417
[5]
First report on a human percutaneous transluminal implantation of a self-expanding valve prosthesis for interventional treatment of aortic valve [J].
Grube, E ;
Laborde, JC ;
Zickmann, B ;
Gerckens, U ;
Felderhoff, T ;
Sauren, B ;
Bootsveld, A ;
Buellesfeld, L ;
Iversen, S .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2005, 66 (04) :465-469
[6]
Percutaneous aortic valve replacement for severe aortic stenosis in high-rick patients using the second- and current third-generation self-expanding CoreValve prosthesis - Device success and 30-day clinical outcome [J].
Grube, Eberhard ;
Schuler, Gerhard ;
Buellesfeld, Lutz ;
Gerckens, Ulrich ;
Linke, Axel ;
Wenaweser, Peter ;
Sauren, Barthel ;
Mohr, Friedrich-Wilhelm ;
Walther, Thomas ;
Zickmann, Bernfried ;
Iversen, Stein ;
Felderhoff, Thomas ;
Cartier, Raymond ;
Bonan, Raoul .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 50 (01) :69-76
[7]
Piazza Nicolo, 2008, EuroIntervention, V4, P242, DOI 10.4244/EIJV4I2A43
[8]
Ree RM, 2008, CAN J ANAESTH, V55, P761, DOI 10.1007/BF03016349
[9]
Percutaneous aortic valve implantation retrograde from the femoral artery [J].
Webb, JG ;
Chandavimol, M ;
Thompson, CR ;
Ricci, DR ;
Carere, RG ;
Munt, BI ;
Buller, CE ;
Pasupati, S ;
Lichtenstein, S .
CIRCULATION, 2006, 113 (06) :842-850
[10]
Percutaneous transarterial aortic valve replacement in selected high-risk patients with aortic stenosis [J].
Webb, John G. ;
Pasupati, Sanjeevan ;
Humphries, Karin ;
Thompson, Christopher ;
Altwegg, Lukas ;
Moss, Robert ;
Sinhal, Ajay ;
Carere, Ronald G. ;
Munt, Brad ;
Ricci, Donald ;
Ye, Jian ;
Cheung, Anson ;
Lichtenstein, Sam V. .
CIRCULATION, 2007, 116 (07) :755-763