Advancements and Challenges in Transcatheter Aortic Valve Replacement (TAVR)

A special issue of Prosthesis (ISSN 2673-1592).

Deadline for manuscript submissions: 20 June 2025 | Viewed by 2113

Special Issue Editors


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Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
Interests: coronary artery disease; valve disease; mechanical circulatory assistance; minimally invasive surgery
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Special Issue Information

Dear Colleagues,

The treatment of aortic stenosis has been improved through transcatheter aortic valve replacement (TAVR). At the beginning, TAVR was only performed in patients at high surgical risk. However, with the accumulation of evidence and the expansion of indications, TAVR is now performed and approved for patients at all risk levels. The developments in valve technology and delivery systems have been rapid, with a concomitant reduction in the complication profile, particularly vascular complications. However, as TAVR continues to advance, several important challenges remain. This review summarizes the historical developments leading to modern TAVR practices and discusses their future trajectory.

This Special Issue will investigate current TAVR practices and discuss future directions. This is a great opportunity to provide a guide to physicians and to offer them a general understanding of the most important issues in this field.

Prof. Dr. Raffaele Serra
Prof. Dr. Giuseppe Filiberto Serraino
Guest Editors

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Keywords

  • transcatheter aortic valve replacement (TAVR)
  • surgical aortic valve replacement (SAVR)
  • aortic stenosis
  • valvular heart disease

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Published Papers (1 paper)

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Research

18 pages, 776 KiB  
Article
The Outcomes for Different Biological Heart Valve Prostheses in Surgical Aortic Valve Replacement before and after the Introduction of Transcatheter Aortic Valve Implantation
by Ivo Deblier, Karl Dossche, Anthony Vanermen and Wilhelm Mistiaen
Prosthesis 2024, 6(3), 708-725; https://doi.org/10.3390/prosthesis6030050 - 20 Jun 2024
Cited by 1 | Viewed by 1496
Abstract
Surgical aortic valve replacement (SAVR) was the only symptom relieving and life-prolonging treatment until transcatheter aortic valve implantation (TAVI) became available. This option was introduced to treat old and high-risk patients. In a series of 2500 consecutive patients referred for SAVR with a [...] Read more.
Surgical aortic valve replacement (SAVR) was the only symptom relieving and life-prolonging treatment until transcatheter aortic valve implantation (TAVI) became available. This option was introduced to treat old and high-risk patients. In a series of 2500 consecutive patients referred for SAVR with a biologic heart valve (BHV) prosthesis, their age, comorbid conditions, the complexity of the procedure, postoperative outcome, need for resources, and long-term survival were compared in patients before versus after the introduction of TAVI. Although the Carpentier-Edwards valve was used in most patients, the outcomes with respect to several other BHV types were studied. Patients undergoing isolated SAVR (i-SAVR) were studied separately from those who underwent SAVR with a concomitant procedure (c-SAVR). The number of referrals increased over time until 2016, whereafter the reimbursement for TAVI broadened. Age, prior percutaneous coronary interventions, diabetes, and chronic renal disease increased over time in both groups, while atrial fibrillation, the need for emergent SAVR, and other comorbid conditions increased significantly only in the c-SAVR group. Postoperative acute renal injury, conduction defects, and bleeding increased over time in both groups. The need for renal replacement therapy increased in both surgical groups, but this was more pronounced in c-SAVR; the need for a pacemaker implant (p < 0.001), blood products, and reintervention increased only in the c-SAVR group. There was a moderate but non-significant increase in the 30-day mortality for both groups over time. Furthermore, the long-term survival of both groups did not change after the introduction of TAVI. The Carpentier-Edwards Perimount valve showed good long-term results for durability. The Perceval device was used in older patients and showed good hemodynamic results, but the need for a postoperative permanent pacemaker implant was high. The results seem to indicate that a broader reimbursement for TAVI was warranted after its introduction in 2008. Nevertheless, with the development of newer devices for SAVR, surgery will remain one of the major treatment options for aortic valve disease. Full article
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