Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic Stenosis

• DOI: 10.1161/01.cir.0000047200.36165.b8
• Publication Date: 2002-12-10T00:55:00Z
• Authors: Alain Cribier; Helene Eltchaninoff; Assaf Bash; Nicolas Borenstein; Christophe Tron; Fabrice Bauer; Genevieve Derumeaux; Frederic Anselme; François Laborde; Martin B. Leon
• Keywords: Heart Valve Prosthesis Implantation; Male; Peripheral Vascular Diseases; Lung Neoplasms; Remission Induction; Calcinosis; Pulmonary Edema; Aortic Valve Stenosis; Middle Aged; Amputation, Surgical; Catheterization; 3. Good health; Pleural Effusion; 03 medical and health sciences; Fatal Outcome; Postoperative Complications; 0302 clinical medicine; Pancreatitis; Ischemia; Sepsis; Disease Progression; Humans; Minimally Invasive Surgical Procedures

Background— The design of a percutaneous implantable prosthetic heart valve has become an important area for investigation. A percutaneously implanted (PHV) composed 3 bovine pericardial leaflets mounted within balloon-expandable stent was developed. After ex vivo testing and animal implantation studies, the first human performed in 57-year-old man with calcific aortic stenosis, cardiogenic shock, subacute leg ischemia, other associated noncardiac diseases. Valve replacement had been declined this patient, balloon valvuloplasty nonsustained results. Methods Results— With use antegrade transseptal approach, PHV successfully diseased native valve, accurate stable positioning, no impairment coronary artery blood flow or mitral function, mild paravalvular regurgitation. Immediately at 48 hours after implantation, function excellent, resulting marked hemodynamic improvement. Over follow-up period 4 months, valvular remained satisfactory as assessed by sequential transesophageal echocardiography, there recurrence failure. However, severe complications occurred, including progressive worsening leading to amputation lack healing, infection, death 17 weeks implantation. Conclusions— Nonsurgical can be achieved immediate midterm clinical further device modifications, additional durability tests, confirmatory implantations, might therapeutic alternative treatment selected patients nonsurgical stenosis.