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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

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Related Experiment Video

Updated: Jul 8, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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[Aortic bioprosthesis implanted percutaneously: three year follow up].

H Eltchaninoff1, C Tron, F Bauer

  • 1Service de cardiologie, hôpital Charles-Nicolle, Rouen. helene.eltchaninoff@chu-rouen.fr

Archives Des Maladies Du Coeur Et Des Vaisseaux
|January 23, 2008
PubMed
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Percutaneous aortic valve replacement offers a viable alternative for high-risk patients with severe aortic stenosis. Early feasibility studies show promising short- and long-term outcomes, with ongoing technological advancements improving safety and efficacy.

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Published on: May 21, 2017

Area of Science:

  • Interventional Cardiology
  • Bioprosthetic Valve Technology
  • Transcatheter Aortic Valve Implantation (TAVI)

Context:

  • Degenerative aortic stenosis poses a significant therapeutic challenge, particularly for patients deemed inoperable or at high risk for traditional surgical valve replacement.
  • Approximately one-third of symptomatic patients with severe aortic stenosis fall into this high-risk surgical category.
  • Early feasibility studies were conducted on critically ill, non-operable patients for compassionate reasons.

Purpose:

  • To evaluate the feasibility and initial outcomes of percutaneous bioprosthesis implantation for severe aortic stenosis in high-risk patients.
  • To assess the safety and efficacy of transcatheter aortic valve implantation (TAVI) using a balloon-expandable pericardial bioprosthesis.
  • To explore different procedural approaches, including anterograde trans-septal and retrograde arterial routes.

Summary:

  • The study involved 36 elderly patients (mean age 80) with multiple comorbidities who were unsuitable for surgery.
  • The percutaneous implantation was attempted via anterograde (n=27, 80% success) or retrograde (n=7, 57% success) routes.
  • Post-implantation echocardiography showed a mean aortic surface area of 1.70 cm2 and a gradient of 9 mmHg, with 5 cases of paravalvular leak.
  • Mortality at 1 month was 16.7% (procedure-related), and at 6 months was 27.8% (non-cardiac causes).
  • No coronary occlusion, prosthesis displacement, or dysfunction occurred. Long-term follow-up showed symptom-free patients with preserved valve function up to 3 years.
  • Technological advancements have simplified the procedure, enhancing safety and improving outcomes. The trans-apical approach is under investigation, and over 280 patients have been implanted to date.

Impact:

  • Percutaneous aortic valve implantation represents a significant advancement in interventional cardiology, offering a life-saving option for previously untreatable patients.
  • Ongoing technological improvements are making TAVI simpler, safer, and more effective, with excellent short- and long-term results.
  • TAVI is poised to become a primary therapeutic modality for high-risk and inoperable patients with aortic stenosis, expanding treatment options and improving patient quality of life.