Aortic Valve Transcatheter Intervention

Aortic Valve Transcatheter Intervention Calcific aortic stenosis (AS) is the most common heart valve anomaly, with a largely age-dependent prevalence, a calculated annual incidence rate in the range of 4-5% in general populations and up to 6% in patients aged 75 years and over.Surgical aortic valve replacement (SAVR) was previously the only option available to patients with symptomatic, severe aortic stenosis. After the first-in-human transcatheter aortic valve implantation (TAVI) was performed by Alain Cribier in 2002, the treatment strategy for patients with symptomatic AS has been revolutionized. Since then, TAVI has grown exponentially, as a result of accruing evidence demonstrating safety and efficacy, and reduced invasiveness compared with SAVR. TAVI devices are continuously expanding to include several valve design options. As this strategy is continuously evolving to treat younger patients and lower-risk populations, aside from the long-term durability of the valve systems, procedural safety will become the focus of newer-generation devices.This book is a practical handbook devoted to the optimization of TAVI procedures, through a focused containment of complications. Through an integrated evaluation of the clinical status, imaging techniques and laboratory findings, the authors provide readers with clear messages on preventive and therapeutic recommendations.

Aortic Valve Transcatheter InterventionCalcific aortic stenosis (AS) is the most common heart valve anomaly, with a largely age-dependent prevalence, a calculated annual incidence rate in the range of 4-5% in general populations and up to 6% in patients aged 75 years and over.Surgical aortic valve replacement (SAVR) was previously the only option available to patients with symptomatic, severe aortic stenosis. After the first-in-human transcatheter aortic valve implantation (TAVI) was performed by Alain Cribier in 2002, the treatment strategy for patients with symptomatic AS has been revolutionized. Since then, TAVI has grown exponentially, as a result of accruing evidence demonstrating safety and efficacy, and reduced invasiveness compared with SAVR. TAVI devices are continuously expanding to include several valve design options. As this strategy is continuously evolving to treat younger patients and lower-risk populations, aside from the long-term durability of the valve systems, procedural safety will become the focus of newer-generation devices.This book is a practical handbook devoted to the optimization of TAVI procedures, through a focused containment of complications. Through an integrated evaluation of the clinical status, imaging techniques and laboratory findings, the authors provide readers with clear messages on preventive and therapeutic recommendations.

List of Contributors viiForeword xiiiAlain Cribier1 Introduction 1Marco Zimarino and Corrado TamburinoPart I General Complications 72 Vascular Complications 9Sebastiano Immè and Claudia I. Tamburino3 Annular Rupture 17Claudia Reddavid, Carmelo Sgroi, Corrado Tamburino, and Marco Barbanti4 Coronary Obstruction 25Henrique B. Ribeiro, Antonio Fernando D. Freire, and Josep Rodés-Cabau5 Cerebrovascular Events 35Luca Testa, Mattia Squillace, Antonio Popolo Rubbio, Matteo Casenghi, Michele Bellamoli, and Francesco Bedogni6 Ventricular Perforation 45Mei Chau, Alfonso Ielasi, and Azeem Latib7 Valve Migration 55Heath SL Adams, Tiffany Patterson, Simon Redwood, and Bernard Prendergast8 Paravalvular Leaks 65Joris Ooms, Zouhair Rahhab, and Nicolas M. Van Mieghem9 Conduction Disturbances 79Itsik Ben-Dor and Ron Waksman10 Leaflet Thrombosis 91Sam Dawkins, Tarun Chakravarty, and Raj Makkar11 Bleeding 97Francesco Radico, Raffaele Piccolo, Umberto Ianni, Sabina Gallina, and Marco Zimarino12 Renal Dysfunction 109Francesco Saia, Gabriele Ghetti, and Nevio TaglieriPart II Specific Complications 11713 Bicuspid Valve 119Anna Franzone, Eugenio Stabile, Plinio Cirillo, and Giovanni Esposito14 Degenerated Aortic Bioprosthesis 129Tania Rodríguez-Gabella, Carlos Cortés, Alberto San Román, and Ignacio J. Amat-Santos15 Low-Flow Low-Gradient Aortic Stenosis 139Francesco Cardaioli, Chiara Fraccaro, Tommaso Fabris, and Giuseppe Tarantini16 Concomitant Mitral Regurgitation 147Felice Gragnano, Carmen Spaccarotella, Andreina Carbone, Augusto Esposito, Paolo Calabrò, and Giampaolo Niccoli17 Alternative Transcatheter Approaches 161Marco De Carlo, Cristina Giannini, and Anna Sonia Petronio18 Transapical and Direct Aortic Approach 171Filippo Capestro, Paolo Berretta, Utz Kappert, and Marco Di Eusanio19 Patients Needing Hemodynamic Support 179Jacopo Andrea Oreglia, Federico De Marco, Francesco Soriano, and Stefano Nava20 Coronary Angiography and Interventions After TAVI 189Stefano Cannata, Matteo Perfetti, Tanya Salvatore, Caterina Gandolfo, and Nicola Maddestra21 Complex Femoral Accesses 201Damiano Regazzoli, Jorge Sanz-Sánchez, Giulio Stefanini, and Bernhard Reimers22 Low-Risk Patients 211Brian C. Case, Toby Rogers, and Ron Waksman23 Gender Peculiarities 229Ridhima Goel, Davide Cao, and Roxana Mehran24 The Pathologist Perspective 237Sho Torii, Yu Sato, Dipti Surve, Maria E. Romero, Aloke V. Finn, and Renu Virmani25 Conclusion: What We Learnt from Clinical Trials and Real-World Experience 253Paolo D'Arrigo, Piera Capranzano, and Davide CapodannoIndex 259