Percutaneous Aortic Valve Replacement: Current Status and Future Perspective

Surgical valve replacement is the definitive therapy for patients with critical aortic stenosis (AS). However, the risk of surgery may be higher in elderly patients with significant comorbidities. Six years after the first in man, percutaneous aortic valve implantation (PAVI) for the treatment of AS currently represents a dynamic field of research and development. Two devices have a CE marked and are under clinical investigation for PAVI, the Edwards-Sapien valve mounted within a balloon-expandable stent and the self-expanding CoreValve. Since the first in-man PAVI by Alain Cribier in 2002, well over 1000 high-risk patients with severe symptomatic AS have been treated using PAVI (as of January 2008). The currently available results suggest that the technique is feasible and provides hemodynamic and clinical improvement for up to two years in patients with critical AS at high risk or with contraindications for surgery. Pending questions concern mainly safety and long-term durability