Progress in Transcatheter Aortic Valve Implantation

In 2002, the first patient underwent transcatheter aortic valve implantation for the treatment of severe symptomatic aortic stenosis. There followed several single-center trials which demonstrated that this new approach was feasible for the treatment of patients who were inoperable or at a very high risk with standard surgical aortic valve replacement. The results of recent multicenter trials using either the Edwards SAPIEN valve or Core Valve Revalving System have shown that the procedure is safe and effective. Moreover, in the majority of series, the two technologies were associated with success rates >90% and 30-day procedural mortality rates <10% even though the trials involved very high-risk patients. In addition, it should be noted that several studies have shown that these prosthetic valves have good hemodynamic characteristics over both the short- and medium-term. The prospective randomized PARTNER study, whose results will be available towards the end of 2010, will make a significant contribution to clearly establishing the safety and efficacy of the percutaneous treatment of aortic valve disease in patients who are inoperable or at a high surgical risk. Finally, we must await long-term results on potential complications and on the durability of transcatheter valves before this treatment approach can be applied in younger patients or those at a low surgical risk.