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Prendergast BD, Baumgartner H, Delgado V, Gérard O, Haude M, Himmelmann A, Iung B, Leafstedt M, Lennartz J, Maisano F, Marinelli EA, Modine T, Mueller M, Redwood SR, Rörick O, Sahyoun C, Saillant E, Søndergaard L, Thoenes M, Thomitzek K, Tschernich M, Vahanian A, Wendler O, Zemke EJ, Bax JJ. Transcatheter heart valve interventions: where are we? Where are we going? Eur Heart J 2020; 40:422-440. [PMID: 30608523 DOI: 10.1093/eurheartj/ehy668] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 11/05/2018] [Indexed: 12/16/2022] Open
Abstract
Transcatheter heart valve interventions have transformed the outcomes of patients with valvular heart disease (VHD) who are unfavourable candidates for surgery. Technological advances have allowed extension of these interventions to younger or lower risk patients and those with other forms of VHD and may in the future permit earlier treatment of VHD in less symptomatic patients or those with moderate disease. The balance of risks and benefits is likely to differ between lower and higher risk patients, and more evidence is needed to evaluate the net benefit of transcatheter technology in these groups. As academic researchers, clinicians, industry, and patient stakeholders collaborate to research these broader indications for transcatheter valve interventions, it is essential to address (i) device durability and deliverability, (ii) specific anatomical needs (e.g. bicuspid aortic valves, aortic regurgitation, mitral and tricuspid valve disease), (iii) operator training, and (iv) the reinforced importance of the multidisciplinary Heart Team.
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Affiliation(s)
| | - Helmut Baumgartner
- Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, RC Leiden, The Netherlands
| | | | - Michael Haude
- Medical Clinic I, Städtische Kliniken Neuss, Neuss, Germany
| | | | - Bernard Iung
- AP-HP, Cardiology Department, Bichat Hospital, Paris-Diderot University, Paris, France
| | | | | | - Francesco Maisano
- Klinik für Herz- und Gefässchirurgie, UniversitätsSpital Zürich, Zürich, Switzerland
| | | | - Thomas Modine
- Department of Cardiovascular Surgery, Hopital Cardiologique CHRU de Lille, Lille, France
| | | | - Simon R Redwood
- Department of Cardiology, St Thomas' Hospital, Westminster Bridge Road, London, UK
| | | | | | | | - Lars Søndergaard
- Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - Alec Vahanian
- AP-HP, Cardiology Department, Bichat Hospital, Paris-Diderot University, Paris, France
| | - Olaf Wendler
- Department of Cardiothoracic Surgery, King's College Hospital, London, UK
| | | | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, RC Leiden, The Netherlands
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