IMR Press / RCM / Volume 23 / Issue 10 / DOI: 10.31083/j.rcm2310349
Open Access Review
From an Unfolding Emergency Treatment to a Universal Shift in Therapy: The History and Evolution of the Catheter-Based Treatment of Aortic Valve Stenosis
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1 Department of Cardiology, Internal Medicine and Conservative Intensive Care Medicine, Vivantes Klinikum Am Urban, 10967 Berlin, Germany
2 Department of Cardiology, Internal Medicine and Conservative Intensive Care Medicine, Vivantes Klinikum Neukölln, 12351 Berlin, Germany
3 Department of Cardiology, Rostock University Medical Center, 18057 Rostock, Germany
*Correspondence: rgea@hotmail.com (Giuseppe D’Ancona)
Academic Editor: Manuel Martínez-Sellés
Rev. Cardiovasc. Med. 2022, 23(10), 349; https://doi.org/10.31083/j.rcm2310349
Submitted: 27 June 2022 | Revised: 15 September 2022 | Accepted: 16 September 2022 | Published: 17 October 2022
(This article belongs to the Section Cardiovascular Intervention and Therapeutics)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Aortic valve stenosis (AVS) is the most frequent valvular heart disease in industrialized countries, presenting with very high mortality if left untreated. While drug treatment can sometimes alleviate symptoms, it fails to stop progression or cure the underlying disease. Until the first decade of this millennium, surgical aortic valve replacement (SAVR) remained the only available therapy option with a positive impact on mortality and morbidity. Even though several studies reported highly positive effects of SAVR regarding the improved quality of life and better physical performance, SAVR remained an intervention that, due to its remarkable complexity and the need for heart-lung machine and cardioplegia, was limited by the patients’ comorbid profile. While unsatisfying hemodynamic results after transcatheter aortic balloon valvuloplasty in high-risk surgical patients limited its adoption as an alternative treatment, it provided the impetus for further interventional approaches to the therapy of AVS. This review considers the invention and development of transcatheter aortic valve implantation (TAVI), which established itself as a catheter-based, minimally invasive procedure over the past decade, and has become an equivalent treatment method for high-risk surgical patients. For that matter, early TAVI concepts, their amendments, and the associated pioneers are recognized for paving the way to a revolutionary diversification in AVS treatment.

Keywords
TAVI
prosthesis
aortic
valve
stenosis
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