Self-expanding transcatheter aortic valves

Introduction

With the worldwide exponential increase in transcatheter aortic valve implantation (TAVI) procedures, there is growing interest in the development by manufacturers of new self-expanding devices. After the first generation of transcatheter heart valves (THVs), several improvements in TAVI systems have been introduced in order to reduce major complications, enhance THV deployment predictability and make the procedure more streamlined.

Design, features of transcatheter heart valves and procedure description

Evolut™

Over the years, the Evolut™ (Medtronic, Minneapolis, MN, USA) has undergone several design changes, which have increased efficiency and, at the same time, facilitated implantation. The first-generation device used bovine pericardial tissue and was implanted with the aid of 24 Fr delivery catheters 11. Grube E, Laborde JC, Zickmann B, Gerckens U, Felderhoff T, Sauren B, Bootsveld A, Buellesfeld L, Iversen S. First report on a human percutaneous transluminal implantation of a self-expanding valve prosthesis for interventional treatment of aortic valve stenosis. Catheter Cardiovasc Interv. 2005;66:465-9. Link. The second generation of implants, consisting of porcine pericardial tissue, had a smaller profile so that they could be implanted using 21 Fr introducers and allow access through a vascular bed with a smaller diameter. Moreover,...