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生物医学工程评论综述™
SJR: 0.207 SNIP: 0.376 CiteScore™: 0.79

ISSN 打印: 0278-940X
ISSN 在线: 1943-619X

生物医学工程评论综述™

DOI: 10.1615/CritRevBiomedEng.2014010464
pages 405-424

Has Percutaneous Aortic Valve Replacement Taken Center Stage in the Treatment of Aortic Valve Disease?

Gideon Praveen Kumar
Institute of High Performance Computing, A*STAR, Singapore
Fangsen Cui
Institute of High Performance Computing, A*STAR, Singapore
Lazar Mathew
Nanotech Research Facility, PSG Institute of Advanced Studies, Tamil Nadu, India
Hwa Liang Leo
Department of Biomedical Engineering, National University of Singapore, Singapore

ABSTRACT

Modern biomedical advances have propelled percutaneous valve replacement into an effective and powerful therapy for many heart valve diseases, especially aortic valve stenosis. Experiences so far suggest that outcomes for new percutaneous valve replacement surgery compare favorably with that of traditional valve surgery in selected patients with severe symptomatic aortic stenosis. The inception of percutaneous aortic valve replacement (PAVR) began in 1992 when the potential for treating valve diseases was demonstrated through a modern technique of endoluminal deployment of a catheter-mounted crimped stented heart valve in an animal model. The first successful demonstration of such novel technique of surgical replacement of a heart valve was performed in 2002, when valve implantation in a patient with aortic stenosis was reported. Despite initial stumbles and a perception of being an uphill task, PAVR has emerged as one of the breakthroughs in surgical procedures. More than 1500 citations were found in PubMed, half of which were available after 2011. This is primarily because more than 50,000 procedures are being performed in more than 40 countries wordwide, with encouraging outcomes, and several stented valves have been launched in the market. This review provides a detailed analysis of the current state of the art of PAVR. Moreover, a competitive landscape of various devices available in the market and their design considerations, biomaterial selections, and overall hemodynamic performance are presented.