TAVI bei isolierter Aortenklappeninsuffizienz und kongenitaler bikuspider Aortenklappe

Abstract

Transcatheter aortic valve implantation (TAVI) has become the standard of care for extreme surgical risk patients with symptomatic severe aortic stenosis. Bicuspid aortic valve (BAV) is the most common congenital heart disease and may lead to aortic stenosis. However, because of this specific anatomic characteristics randomized studies to date have excluded patients with BAV. Noncalcified or predominant aortic regurgitation has typically been considered a contraindication for TAVI due to the risk of valve dislocation and a consequence of insufficient anchoring.

This paper gives an overview of bicuspide aortic valve stenosis and predominant aortic regurgitation, two „off-label“ indications for TAVI.

• Literatur

• 1 Cribier A, Eltchaninoff H, Bash A et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation 2002; 106: 3006-3008
• 2 Leon MB, Smith CR, Mack M et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010; 363: 1597-1607
• 3 Holmes Jr DR, Mack MJ, Kaul S et al. 2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement. J Thorac Cardiovasc Surg 2012; 144: e29-84
• 4 Wijesinghe N, Ye J, Rodés-Cabau J et al. Transcatheter aortic valve implantation in patients with bicuspid aortic valve stenosis. JACC Cardiovasc Interv 2010; 3: 1122-1125
• 5 Dhillon PS, Kakouros N, Brecker SJ. Transcatheter aortic valve replacement for symptomatic severe aortic valve regurgitation. Heart 2010; 96: 810
• 6 Seiffert M, Diemert P, Koschyk D et al. Transapical implantation of a second-generation transcatheter heart valve in patients with noncalcified aortic regurgitation. JACC Cardiovasc Interv 2013; 6: 590-597
• 7 Roy DA, Schaefer U, Guetta V et al. Transcatheter aortic valve implantation for pure severe native aortic valve regurgitation. J Am Coll Cardiol 2013; 61: 1577-1584
• 8 Treede 1 H, Mohr FW, Baldus S et al. Transapical transcatheter aortic valve implantation using the JenaValve™ system: acute and 30-day results of the multicentre CE-mark study. Eur J Cardiothorac Surg 2012; 41: e131-8
• 9 Siu SC, Silversides CK. Bicuspid aortic valve disease. J Am Coll Cardiol 2010; 55: 2789-2800
• 10 Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. J Thorac Cardiovasc Surg 2007; 133: 1226-1233
• 11 Costopoulos C, Latib A, Maisano F et al. Comparison of results of transcatheter aortic valve implantation in patients with severely stenotic bicuspid versus tricuspid or nonbicuspid valves. Am J Cardiol 2014; 113: 1390-1393
• 12 Kochman J, Huczek Z, Scisło P et al. Comparison of one- and 12-month outcomes of transcatheter aortic valve replacement in patients with severely stenotic bicuspid versus tricuspid aortic valves (results from a multicenter registry). Am J Cardiol 2014; 114: 757-762
• 13 Nombela-Franco L, Rodés-Cabau J, DeLarochellière R et al. Predictive factors, efficacy, and safety of balloon post-dilation after transcatheter aortic valve implantation with a balloon-expandable valve. JACC Cardiovasc Interv 2012; 5: 499-512
• 14 Mylotte D, Lefevre T, Søndergaard L et al. Transcatheter aortic valve replacement in bicuspid aortic valve disease. J Am Coll Cardiol 2014; 64: 2330-2339
• 15 Zoghbi WA, Enriquez-Sarano M, Foster E et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 2003; 16: 777-802