Related Experiment Video
Updated: Feb 27, 2026
05:31
Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
3.4K
Structural valve deterioration after transcatheter aortic valve implantation
Farid Foroutan1,2, Gordon H Guyatt1, Catherine M Otto3
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Heart (British Cardiac Society)
|July 8, 2017
Summary
Structural valve deterioration (SVD) is infrequent within 5 years after transcatheter aortic valve implantation (TAVI). Longer follow-up studies are needed to assess SVD impact in younger, lower-risk patients receiving TAVI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomaterials Science
Background:
- Transcatheter aortic valve implantation (TAVI) is increasingly used for severe symptomatic aortic stenosis.
- Long-term durability of TAVI devices is a concern, especially in younger, lower-risk patients.
- Systematic review and meta-analysis to assess structural valve deterioration (SVD) frequency post-TAVI.
Purpose of the Study:
- To determine the incidence of structural valve deterioration (SVD) after transcatheter aortic valve implantation (TAVI).
- To evaluate the need for re-intervention due to SVD in patients undergoing TAVI.
- To inform recommendations for younger patients with longer life expectancies.
Main Methods:
- Systematic review and meta-analysis of observational studies.
- Searched Medline, Embase, Cochrane databases (2002-2016).
- Included studies with ≥2 years follow-up; assessed risk of bias and used GRADE for evidence quality.
Main Results:
- Pooled incidence of SVD was 28.08 per 10,000 patient-years (95% CI 2.46-73.44).
- SVD occurred at a rate of 0-1.34 per 100 patient-years across 13 studies (8914 patients).
- 12% of patients with SVD required valve re-intervention; evidence quality was moderate.
Conclusions:
- Structural valve deterioration is likely infrequent within the first 5 years post-TAVI.
- Further long-term studies (>10 years) are necessary to fully understand SVD impact and re-intervention needs.
- This information is crucial for guiding TAVI use in patients with longer life expectancies.
Related Concept Videos
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
680
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
680
01:25Aortic Regurgitation III: Medical Management
512
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
512
01:15Aortic Regurgitation I: Introduction
874
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
874
01:26Aneurysm III: Interprofessional Care
387
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...
387
01:26Mitral Stenosis III: Medical Management
365
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
365
01:22Mitral Valve Prolapse II: Assessment and Management
827
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
827