Aktuelle Kardiologie 2016; 5(01): 52-58
DOI: 10.1055/s-0041-110767
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Die Therapie der Aortenklappenstenose mit TAVI-Systemen der nächsten Generation

Therapy of Aortic Valve Stenosis Using Next Generation Transcatheter Heart Valves
A. Schäfer
1   Klinik und Poliklinik für Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg
,
L. Conradi
1   Klinik und Poliklinik für Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg
,
U. Schäfer
2   Klinik für Allgemeine und Interventionelle Kardiologie, Universitäres Herzzentrum Hamburg
› Author Affiliations
Further Information

Publication History

Publication Date:
23 February 2016 (online)

Zusammenfassung

Die Transkatheter-Implantation von Aortenklappen (TAVI) stellt eine etablierte Therapieoption zur Behandlung der Aortenklappenstenose bei älteren Hochrisikopatienten dar. Die kommerziell verfügbaren Transkatheter-Herzklappen (THV) CoreValve® (Medtronic, Inc., Minneapolis, MN, USA) und Edwards SAPIEN™ (Edwards Lifesciences, Irvine, CA, USA), wurden bereits bei mehreren tausend Prozeduren eingesetzt und bereiteten der TAVI-Prozedur in Europa den Weg. In der Zwischenzeit haben verschiedene Unternehmen TAVI-Technologien entwickelt, die unterschiedliche Technikplattformen benutzen. Die Entwicklung dieser neuen Technologien wurde größtenteils durch offensichtliche Nachteile der Erst-Generations-THV gefördert. Im Folgenden soll ein Überblick über eine Auswahl von TAVI-Systemen der nächsten Generation gegeben werden.

Abstract

Transcatheter aortic valve implantation (TAVI) is an established therapy for aortic valve stenosis in the elderly and high-risk patients. Commercially available transcatheter heart valves (THV) like the CoreValve® (Medtronic, Inc., Minneapolis, MN, USA) and the Edwards SAPIEN™ (Edwards Lifesciences, Irvine, CA, USA) were utilized in several thousand procedures and pioneered transcatheter heart valve procedures in Europe. In the meantime different companies developed TAVI systems using various technologies, mainly triggered by obvious shortcomings of current devices. In the following an overview of selected next-generation TAVI devices is given.

 
  • Literatur

  • 1 Adams DH, Popma JJ, Reardon MJ et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med 2014; 370: 1790-1798
  • 2 Eltchaninoff H, Prat A, Gilard M et al. Transcatheter aortic valve implantation: early results of the FRANCE (FRench Aortic National CoreValve and Edwards) registry. Eur Heart J 2011; 32: 191-197
  • 3 Walther T, Simon P, Dewey T et al. Transapical minimally invasive aortic valve implantation: multicenter experience. Circulation 2007; 116: I240-I245
  • 4 Thomas M, Schymik G, Walther T et al. Thirty-day results of the SAPIEN aortic Bioprosthesis European Outcome (SOURCE) Registry: A European registry of transcatheter aortic valve implantation using the Edwards SAPIEN valve. Circulation 2010; 122: 62-69
  • 5 Gurvitch R, Tay EL, Wijesinghe N et al. Transcatheter aortic valve implantation: lessons from the learning curve of the first 270 high-risk patients. Catheter Cardiovasc Interv 2011; 78: 977-984
  • 6 Erkapic D, Kim WK, Weber M et al. Electrocardiographic and further predictors for permanent pacemaker requirement after transcatheter aortic valve implantation. Europace 2010; 12: 1188-1190
  • 7 Abdel-Wahab M, Zahn R, Horack M et al. Aortic regurgitation after transcatheter aortic valve implantation: incidence and early outcome. Results from the German transcatheter aortic valve interventions registry. Heart 2011; 97: 899-906
  • 8 Vergnat M, Henaine R, Kalejs M et al. A new self-expanding aortic stent valve with annular fixation: in vitro haemodynamic assessment. Eur J Cardiothorac Surg 2009; 35: 970-975 discussion 975–976
  • 9 Walther T, Mollmann H, van Linden A et al. Transcatheter aortic valve implantation transapical: step by step. Semin Thorac Cardiovasc Surg 2011; 23: 55-61
  • 10 Leon MB, Piazza N, Nikolsky E et al. Standardized endpoint definitions for transcatheter aortic valve implantation clinical trials: a consensus report from the Valve Academic Research Consortium. Eur Heart J 2011; 32: 205-217
  • 11 Kempfert J, Treede H, Rastan AJ et al. Transapical aortic valve implantation using a new self-expandable bioprosthesis (ACURATE TA): 6-month outcomes. Eur J Cardiothorac Surg 2013; 43: 52-56 discussion 57
  • 12 Webb J, Gerosa G, Lefèvre T et al. Multicenter evaluation of a next-generation balloon-expandable transcatheter aortic valve. J Am Coll Cardiol 2014; 64: 2235-2243
  • 13 Meredith Am IT, Walters DL, Dumonteil N et al. Transcatheter aortic valve replacement for severe symptomatic aortic stenosis using a repositionable valvesystem: 30-day primary endpoint results from the REPRISE II study. J Am Coll Cardiol 2014; 64: 1339-1348
  • 14 Vasques F, Messori A, Lucenteforte E et al. Immediate and late outcome of patients aged 80 years and older undergoing isolated aortic valve replacement: a systematic review and meta-analysis of 48 studies. Am Heart J 2012; 163: 477-485
  • 15 Van Mieghem NM, Tchetche D, Chieffo A et al. Incidence, predictors, and implications of access site complications with transfemoral transcatheter aortic valve implantation. Am J Cardiol 2012; 110: 1361-1367
  • 16 Rodes-Cabau J, Webb JG, Cheung A et al. Transcatheter aortic valve implantation for the treatment of severe symptomatic aortic stenosis in patients at very high or prohibitive surgical risk: acute and late outcomes of the multicenter Canadian experience. J Am Coll Cardiol 2010; 55: 1080-1090