head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing
ISSN: 1312-773X (Online)
Issue: 2018, vol. 24, issue2
Subject Area: Medicine
DOI: 10.5272/jimab.2018242.2055
Published online: 19 June 2018

Review article

J of IMAB. 2018 Apr-Jun;24(2):2055-2057
Veselin Valkov1ORCID logo Corresponding Autoremail, Dobrin Kalchev1, Atanas Kostadinov1ORCID logo, Yavor Kashlov2, Branimir Kanazirev2ORCID logo,
1) First Clinic of Cardiology, UMHAT St. Marina, Faculty of Medicine, Medical University, Varna, Bulgaria.
2) Department of Internal Medicine, UMHAT St. Marina, Faculty of Medicine, Medical University, Varna, Bulgaria.

The only known treatment for high grade degenerative aortic stenosis until the beginning of this century was surgical replacement with a biological or mechanical valve. For the high risk or inoperable patients this treatment was unacceptable, with a high mortality rate in both operated and non-operated cases. The new concept of transcatheter valve implantation was developed especially for this group of patients, which number continues to increase. It is a really attractive idea, being able to offer a non-invasive and low risk procedure for a patient who is not considered a good candidate for conventional operation. The increase in the operators experience reduces the rate of mortality in TAVI even more. Both TAVI and surgical valves are biological. The technology used for production of the balloon expandable and self-expandable valves is much more advanced. The biological tissue used in both types of valve is prone to degeneration due to different factors and can lead to valvular dysfunction. The surgical valves are made from porcine or bovine tissue and have a lifespan between 10 and 15 years. In some cases, the dysfunction occurs much sooner. If that happens the patient needs a re-replacement valve surgery. Since such a procedure is risky the patient is usually referred for valve-in-valve TAVI.

Keywords: Transcatheter aortic-valve implantation (TAVI), aortic stenosis, bioprosthetic valvular dysfunction,

pdf - Download FULL TEXT /PDF 492 KB/
Please cite this article as: Valkov V, Kalchev D, Kostadinov A, Kashlov Y, KanazirevB. Durability of biological prostheses used for management of degenerative aortic stenosis – TAVR vs. SAVR. J of IMAB. 2018 Apr-Jun;24(2):2055-2057. DOI: 10.5272/jimab.2018242.2055

Corresponding AutorCorrespondence to: Veselin Valkov, First Clinic of Cardiology, Department of Internal Medicine, UMHAT St.Marina, Varna; 1, Hr. Smirnensky blvd., Varna, Bulgaria; E-mail: vd.valkoff@abv.bg,

1. Cheng TO. The international textbook of cardiology. Pergamon Press, Oxford/New York; 1986-7:529.
2. Cribier A, Savin T, Saoudi N, Rocha P, Berland J, Letac B.  Percutaneous transluminal valvuloplasty of acquired aortic stenosis in elderly patients: an alternative to valve replacement? Lancet. 1986 Jan 11;1(8472):63-7. [PubMed] [CrossRef]
3. Letac B, Cribier A, Koning R, Bellefleur J. Results of percutaneous transluminal valvuloplasty in 218 adults with valvular aortic stenosis. Am J Cardiol. 1988 Sep 15;62(9):598-605 [PubMed]
4. [No authors listed] Percutaneous balloon aortic valvuloplasty. Acute and 30-day follow-up results in 674 patients from the NHLBI Balloon Valvuloplasty Registry. Circulation. 1991 Dec;84(6):2383-97. [PubMed]
5. Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description.  Circulation. 2002 Dec 10;106(24):3006-8.  [PubMed]
6. Dellgren G, Tirone D, Raanani E, Armstrong S, Ivanov J, Rakowski H. Late hemodynamic and clinical outcomes of aortic valve replacement with the Carpentier-Edwards Perimount pericardial bioprosthesis. J Thorac Cardiovasc Surg. 2002 Jul;124(1):146-54. [PubMed] [CrossRef]
7. Frater RW, Furlong P, Cosgrove DM, Okies JE,  Colburn LQ,  Katz AS, et al. Long-term durability and patient functional status of the Carpentier-Edwards Perimount pericardial bioprosthesis in the aortic position. J Heart Valve Dis. 1998 Jan;7(1):48-53. [PubMed]
8. Milano AD, Bortolotti U, Mazzucco A, Guerra F, Stellin G, Talenti E, et al. Performance of the Hancock Porcine Bioprosthesis Following Aortic Valve Replacement: Considerations Based on a 15-Year Experience. Ann Thorac Surg. 1988 Aug;46(2):216-22. [PubMed] [CrossRef]
9. Moat NE, Ludman P, de Belder MA, Bridgewater B, Cunningham AD, Young CP, et al. Long-term outcomes after transcatheter aortic valve implantation in high-risk patients with severe aortic stenosis: the U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) Registry. J Am Coll Cardiol. 2011 Nov 8;58(20):2130-8. [PubMed] [CrossRef]
10. Dvir D. First look at long-term durability of transcatheter heart valves: assessment of valve function up to 10 years after implantation. Presented at: EuroPCR 2016. 17-20 May 2016. Paris, France.
11. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017 Jun 20;135(25):e1159-e1195. [PubMed] [CrossRef]
12. Hoffmann R, Möllmann H, Lotfi S. Transcatheter aortic valve-in-valve implantation of a CoreValve in a degenerated stenotic Sapien heart valve prosthesis. Catheter Cardiovasc Interv. 2013 Dec 1;82(7):E922-5. [PubMed] [CrossRef]
13. Bruschi G, DeMarco F, Oreglia J, Colombo P, Fratto P, Lullo F, et al. Transcatheter aortic valve-in-valve implantation of a CoreValve in a degenerated aortic bioprosthesis. J Cardiovasc Med (Hagerstown). 2010 Mar;11(3):182-5. [PubMed] [CrossRef]
14. Schmidt T, Frerker C, Alessandrini H, Schlüter M, Kreidel F, Schäfer U, et al. Redo TAVI: initial experience at two German centres. EuroIntervention. 2016 Sep 18;12(7):875-82. [PubMed] [CrossRef]
15. Kappetein AP, Head SJ, Ge´ne´reux P, Piazza N, van Mieghem NM, Blackstone EH, et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document (VARC-2). Eur J Cardiothorac Surg. 2012 Nov;42(5):S45-60. [PubMed] [CrossRef].

Received: 27 April 2018
Published online: 19 June 2018

back to Online Journal