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Developments in transcatheter aortic bioprosthesis durability.

Anna Sonia Petronio1, Cristina Giannini1

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Expert Review of Cardiovascular Therapy
|December 19, 2019
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Summary

Transcatheter aortic valve implantation (TAVI) bioprostheses show encouraging midterm durability. However, longer-term data is crucial to assess structural valve deterioration (SVD) in younger, lower-risk patients before TAVI replaces surgery.

Keywords:
Bioprosthetic valve failureDurabilityStructural valve deteriorationSurgical aortic valve replacementTAVI

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Area of Science:

  • Cardiovascular Medicine
  • Biomaterials Science
  • Interventional Cardiology

Background:

  • Valve durability is a key concern for transcatheter aortic valve implantation (TAVI).
  • The patient demographic for TAVI is shifting towards younger, lower-risk individuals requiring long-term device performance.
  • Structural valve deterioration (SVD) is a primary limitation of bioprosthetic valves.

Purpose of the Study:

  • To review potential mechanisms and rates of SVD in transcatheter bioprostheses.
  • To provide an objective evaluation of TAVI prostheses longevity.
  • To compare transcatheter bioprostheses durability with surgical bioprostheses.

Main Methods:

  • Literature review of studies on transcatheter bioprostheses.
  • Analysis of standardized definitions for SVD by EAPCI, ESC, and EACTS.
  • Comparison of midterm durability data for TAVI devices.

Main Results:

  • Standardized SVD definitions enable objective evaluation and comparison of TAVI prostheses.
  • Midterm durability results for transcatheter bioprostheses are encouraging.
  • Data on clinical outcomes and durability of TAVI beyond 5 years remains limited.

Conclusions:

  • While midterm TAVI bioprosthesis durability is promising, long-term data is essential.
  • Further evidence on longevity is required before TAVI can be recommended over surgery for younger, lower-risk patients.
  • Understanding SVD mechanisms is critical for improving transcatheter valve technology.