Evolution in transcatheter aortic valve replacement: the CoreValve? self-expanding prosthetic aortic valve

摘要

Aortic stenosis is one of the more commonly encountered disease processes in valvular heart disease, affecting over 300,000 people worldwide. Surgical replacement of the aortic valve has been the mainstay of therapy for decades; however, in certain patients with prohibitively high-risk comorbidities, surgery is not a viable option. The advent of transcatheter aortic valve replacement has come to the forefront of interventional cardiology, promising therapeutic options primarily for those at high surgical risk, but possibly even for intermediate-risk patients as well. The Medtronic CoreValve? Prosthesis (Medtronic Inc., MN, USA) is a self-expanding valve system designed for transcatheter aortic valve replacement. It consists of a trileaflet bioprosthetic porcine pericardial tissue valve, which is mounted and sutured in a self-expanding nitinol stent. The feasibility and efficacy of percutaneous implantation has been studied worldwide with a large, multicenter, randomized, USA-based clinical trial currently underway.