Improvement To Self Expanding Stents In Transcatheter Aortic Valve Replacements

2326 words - 10 pages

“Heart valve disease” refers to the potentially life-threatening condition in which a patient’s heart valves do not operate properly. One cause of heart valve disease is regurgitation, in which some amount of backflow is present, causing hemodynamic problems. However this type of condition most often affects the mitral valve, and its treatment has evolved to avoid valve replacement in favor of reparative techniques2, 4. For the aortic valve, the most common type of dysfunction is aortic stenosis, in which the flaps of the heart valves can no longer open fully, and not enough blood is able to pass through. In contrast to treatment for prolapse in the mitral valve, which is the main cause of regurgitation, aortic stenosis (AS) is primarily resolved through valve replacement. This is because aortic stenosis only causes symptoms after it is past the point of being considered severe3.
Stenosis most frequently occurs as the result of a calcification, making it especially prevalent among senior citizens, who are more prone to calcium deposits. A John Muir Health patient advisory article cites a figure of 1,500,000 patients living with AS in the United States, 250,000 of whom have what is considered to be severe, but non-symptomatic AS, and 250,000 of whom have severe, symptomatic AS. Half of those with symptomatic AS survive an average of only two years5. The widespread extend of aortic heart valve disease makes it a key target for the medical device industry, especially because of the patients’ range of age. The fact that many older patients also suffer from other illnesses associated with old age makes open-heart valve replacement non-ideal. Many patients would not survive the trauma of such a surgery. Furthermore, open-heart surgery is very invasive and carries a heavy cost, both pre-op and post-op, making it non-ideal even in patients for whom it is a viable option. In relatively recent years, transcatheter approaches have been emerging in the treatment of failing aortic valves. Transcatheter aortic valve replacement (TAVR) is a procedure in which a prosthetic heart valve attached to a stent is guided through a vein in the thigh or chest and expanded to affix the new valve over the old one. The expansion of the stent can be accomplished using an inflating balloon to manually form it. Otherwise, a memory-metal alloy can be used so that the stent returns to an inflated shape on its own when released from a sheath. The second of these two options is the best insofar as it simplifies the procedure. Research to date indicates that a memory-metal stent and a transcatheter approach is the best way known to replace an aortic valve, while minimizing cost, discomfort, and risk to the patient1.
Aside from the stent itself, a system for TAVR has three basic components: the prosthetic valve, a catheter delivery system, and a guidance system. Prosthetic valves can be inorganic or made of a biomaterial. Inorganic metal valves have the advantage of longevity;...

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