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Related Experiment Video

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Balloon-expandable prostheses for transcatheter aortic valve replacement.

Henrique Barbosa Ribeiro1, Marina Urena1, Ricardo Allende1

  • 1Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.

Progress in Cardiovascular Diseases
|May 20, 2014
PubMed
Summary

Balloon-expandable transcatheter heart valves (THV) are safe and effective for transcatheter aortic valve replacement (TAVR). Studies show excellent hemodynamics and durability, supporting broader use in lower-risk patients.

Keywords:
Aortic stenosisBalloon-expandableTranscatheter aortic Valve replacementTranscatheter heart valve

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials Engineering

Background:

  • Transcatheter aortic valve replacement (TAVR) has evolved significantly with balloon-expandable transcatheter heart valve (THV) technology.
  • Early TAVR utilized balloon-expandable systems, involving a foldable biological valve crimped onto a stent frame for implantation via balloon inflation.

Purpose of the Study:

  • To review the role and outcomes of balloon-expandable THV systems in TAVR.
  • To assess the safety, efficacy, and durability of this technology based on clinical trials and registries.

Main Methods:

  • Analysis of data from large multicenter trials and registries, including the randomized Placement of Aortic Transcatheter Valves (PARTNER) trial.
  • Evaluation of hemodynamic performance, paravalvular regurgitation rates, and long-term valve durability (up to 5-year follow-up).

Main Results:

  • Balloon-expandable THVs demonstrated superiority over medical treatment and non-inferiority to surgical aortic valve replacement in high-risk patients.
  • Excellent hemodynamic results were observed, with most patients achieving a residual mean gradient below 15 mm Hg.
  • While mild paravalvular aortic regurgitation was common, severe regurgitation occurred in less than 10% of patients. Valve durability studies showed sustained performance over 5 years.

Conclusions:

  • Balloon-expandable THV technology is a safe and effective option for TAVR, offering good hemodynamic function and durability.
  • Ongoing technological advancements and trials (e.g., Sapien 3 valve, PARTNER II trial) are expected to expand TAVR use to lower-risk patient populations.