Medical search (Heart Valve Prosthesis • Web)
Surgical replacement of the aortic valve, which requires open heart surgery, is the standard treatment for severe aortic stenosis. In conventional surgical aortic valve replacement (SAVR), the breastbone is fully or partially split (sternotomy or mini-sternotomy) and the aorta is closed off with a clamp (aortic cross-clamping). The heart is then stopped and the patient's blood is routed through a heart-lung machine (cardiopulmonary bypass). The aortic valve is removed and the aortic annulus (the ring of heart tissue where the valve sits) is cleared of calcified deposits. A mechanical or bioprosthetic (made of animal heart tissue) valve is then sewn into place.5-7
Artificial heart valve - WikiVisually
Up to one-third of patients with severe aortic stenosis are ineligible for SAVR due to age, comorbidities, or technical constraints (e.g., scarring from previous cardiac surgery or calcification of the aorta).4,7,22 TAVR is a less invasive procedure, in which the valve is passed into the heart through a catheter inserted into the femoral artery in the leg or between the ribs into the left ventricle. The new valve is positioned within the existing dysfunctional valve. However, this can interfere with the attachment of the new valve, and up to 18% of patients have moderate to severe paravalvular regurgitation (leakage of blood around the valve) after TAVR.23,24 In addition, the closed nature of the procedure precludes removal of any calcified deposits on the original valve. TAVR is not suitable for patients with small peripheral vessels or a heavily diseased aorta, and other cardiac procedures cannot be done at the same time.25
Most patients with aortic stenosis are elderly and have an elevated operative risk. In some countries, more than 20% of SAVR is performed in patients older than 80 years.19 With estimates that seniors will constitute 21% of the Canadian population by 2026,39 the demand for minimally invasive valve replacement is likely to increase.
was rheumatic heart disease (30 patients), prosthetic valve ..
Quick placement of the valve during SU-AVR reduces the aortic cross-clamp and cardiopulmonary bypass (CPB) time, potentially reducing post-operative complications.9,10 Damage to the aortic annulus and surrounding tissue is minimized during SU-AVR and the removal of aortic calcifications reduces the risk of an embolism (blockage of blood vessels by undissolved material in the bloodstream).8,11 Other purported advantages of SU-AVR include the ability to conduct other cardiac procedures, such as heart bypass surgery, at the time of valve replacement, as well as a shorter ventilation time and length of hospital and intensive care unit (ICU) stay.7,10
The Perceval S Aortic Heart Valve: ..
The heart's aortic valve opens and closes during heart contractions to allow the one-way flow of oxygenated blood from the heart into the aorta. If the aortic valve becomes narrowed (stenosed), the heart must work harder to push the blood into the aorta.1 The heart muscle thickens over time to compensate for the extra workload, but after 10 to 20 years, symptoms of heart weakness develop in some individuals. These symptoms — which include chest pain, heart palpitations, breathlessness, and dizziness or faintness — often occur during exertion. Without treatment, most patients with symptomatic aortic stenosis will develop heart failure and die within five years. Patients have a mean survival time of 4.5 years after the onset of chest pain, 2.6 years after the onset of fainting, and less than a year after the onset of left heart failure.2-4
New sutureless aortic valve prosthesis: ..
Three manufacturers currently produce sutureless aortic valves; each valve has a distinct design and deployment system, but none are commercially available in North America (Table 1). The Perceval S valve has been used in Canada through the Health Canada Special Access Programme.12 A recent conference abstract reported that 63 patients received the 3f Enable aortic valve at the McGill University Health Centre between September 2012 and October 2014 (also through the Special Access Programme).13,14 A patient registry has been established to collect evidence on the McGill centre's experience with this technology. There is no indication that the EDWARDS INTUITY Elite valves have been used in Canada to date.
Transcatheter Aortic Valve Replacement or Open Heart Surgery ..
Aortic stenosis, the most common heart valve disease in North America, may be caused by congenital (present at birth) aortic valve defects or, more frequently, acquired. Acquired stenosis is typically caused by age-related progressive buildup of calcium and scarring of the aortic valve.11 It affects 2% of people older than 65 years, 3% of people older than 75 years, and up to 8% of people aged 80 years or older.3 The risk factors for degenerative