Percutaneous aortic valve r...( single centre feasibility studies (the...),Health

single centre feasibility studies (the I-REVIVE and the RECAST studies). Three patients have now reached two years of follow-up. The valve performance has been excellent and there has not been a single case of valve failure when the valve was successfully placed (80% of the cases). High mortality during follow-up has been related to non valvular causes, mainly the evolution of life-threatening comorbidities.

Challenges remain as the procedure is complex when performed via the antegrade/transseptal route, whereas the less demanding retrograde route has been frequently associated with failures in crossing the native valve. Also, paravalvular leaks can occur (moderate to severe in 25%), which is undesirable despite not being a clinical issue. One reason for the leak has been to have a single valve size (23mm in diameter), too small for some patients.

Two most recent developments relate to a custom retrograde delivery system, as well as a larger 26mm size valve. Dr John Webb (Vancouver, Canada) is the only physician approved yet for investigating these new iterations. He has successfully performed a number of cases using the custom retrograde delivery system and the 26mm valve. The retrograde route is much simpler and can be performed in about one hour. The rate and severity of paravalvular leak has dramatically decreased with the use of the 26mm valve.

Two multicentre studies have just begun enrollment in Europe (REVIVE trial) and the US (REVIVAL trial) that will help to determine the future of this revolutionary and promising interventional cardiology procedure.

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Contact: Gina Dellios
gdellios@escardio.org
+33(0) 493-38-6442
European Society of Cardiology
5-Sep-2005

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