Transcatheter aortic valve-in-valve (VIV) is an established treatment of degenerative surgical bioprostheses in patients at high operative risk and was approved by the US Food and Drug Administration in 2015. The aortic VIV procedure is not currently approved to treat…
Background The transfemoral approach remains the first-line access choice for transcatheter aortic valve replacement (TAVR). Initially up to a third of patients were unsuitable for the transfemoral approach, although this has decreased to less than 10% with contemporary valve designs.…
Complications Operators have to be prepared for all emergencies when performing transcatheter aortic valve replacement (TAVR). Complications should be managed by the team with predefined and discussed protocols, and these will be determined by local expertise. Bailout equipment should be…
Self-expanding transcatheter aortic valve replacement: The medtronic corevalve system Currently in the United States, the most widely used self-expanding transcatheter aortic valve is the Medtronic CoreValve system. This transcatheter valve is made of a self-expanding nitinol frame with leaflets composed…
Introduction The only balloon-expandable valve currently on the market is the Edward Sapien Heart valve manufactured by Edwards Life Sciences. This chapter will focus on the procedural techniques involved in the use of this balloon-expandable prosthesis. Edwards sapien balloon-expandable heart…
Background Aortic stenosis is the most common valvular heart disease in the elderly population, with a prevalence of approximately 3% in patients over 75 years old. The prognosis of symptomatic severe aortic stenosis is poor, with a 50% mortality rate…
Background Aortic stenosis (AS) is common in the elderly population, with a prevalence of approximately 3% in patients over 75 years old. The prognosis of symptomatic severe AS is poor, with a 50% mortality rate at 2 years; therefore valve…
Transseptal catherization was first described by Ross, Braunwald, and Morrow in 1959 as a feasible method to obtain direct left atrial (LA) pressure measurements. Although the use of transseptal puncture (TSP) for hemodynamic assessment had since declined due to the…
Introduction Invasive hemodynamic assessment is a critical part of structural intervention. Imaging and hemodynamics are complementary, and both need to be mastered for effectiveness in structural heart disease (SHD) interventions. Indications for diagnostic invasive assessment include: 1. The diagnosis remains…
Introduction The field of transcatheter structural heart interventions has grown tremendously in recent years. Because operators are not able to directly visualize the cardiac anatomy during percutaneous procedures, live imaging is a critical component of safely and successfully performing these…