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Current Trends and Future Challenges in Transcatheter Aortic Valve Replacement
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Current Trends and Future Challenges in Transcatheter Aortic Valve Replacement

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 520

Special Issue Editors

Prof. Dr. Florence Leclercq

E-Mail Website
Guest Editor
Department of Cardiology, Arnaud de Villeneuve University Hospital, 34295 Montpellier, France
Interests: interventional cardiology; valvulopathy; TAVR; TMVR; TEER; tricuspid valve repair and replacement; coronary artery diseases; acute coronary syndromes; heart failure; pathophysiology of ischemic heart disease; MINOCA
Dr. Mariama Akodad

E-Mail Website
Co-Guest Editor
Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France
Interests: valvular disease; interventional cardiology; structural heart disease; TAVR; TMVR; TEER; tricuspid valve repair and replacement; CCTA; structural CT

Special Issue Information

Dear Colleagues,

The experience of operators and improvement in the technique have resulted in a drastic reduction in complications following TAVR in patients with lower surgical risk. In parallel, the procedure has been considerably simplified with a routine default strategy including local anesthesia in the cath lab, percutaneous femoral approach, radial secondary access, prosthesis implantation without predilatation, and left ventricle wire pacing without secondary venous access. TAVR has become a routine procedure allowing for rapid recovery and early ambulation and discharge, with an improvement in patient satisfaction; The aim is also reduction in hospital costs but without compromising safety. The future challenges of TAVR may be related to rationalizing the management of conductive disorders and pace maker indications, prevention of asymptomatic thrombosis, concerns regarding durability and reintervention in younger and lower risk patients, coronary access, and also the choice of device regarding valve and aortic anatomy. With this Special Issue, we hope to encourage submissions that discuss the current state of the art, address ongoing knowledge gaps, and focus on ongoing controversies related to TAVR.

Prof. Dr. Florence Leclercq
Dr. Mariama Akodad
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • TAVR
  • simplification
  • coronary access
  • redoTAVR
  • pre- and post-TAVR imaging
  • conductive disorders after TAVR

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Published Papers (2 papers)

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Review

12 pages, 897 KiB  
Review
Review Article: Contemporary Transcatheter Heart Valves for TAVI in Bicuspid Aortic Anatomy
by Chrysavgi Simopoulou, Omar Oliva, Vincenzo Cesario, Nicolas Dumonteil, Didier Tchetche and Chiara De Biase
J. Clin. Med. 2025, 14(8), 2838; https://doi.org/10.3390/jcm14082838 - 20 Apr 2025
Abstract
Bicuspid aortic valve (BAV) is the most common congenital heart disease, affecting 0.5–2% of the population and often leading to early aortic valve degeneration. While surgical aortic valve replacement (SAVR) remains the gold standard for treating severe bicuspid aortic stenosis (AS), transcatheter aortic [...] Read more.
Bicuspid aortic valve (BAV) is the most common congenital heart disease, affecting 0.5–2% of the population and often leading to early aortic valve degeneration. While surgical aortic valve replacement (SAVR) remains the gold standard for treating severe bicuspid aortic stenosis (AS), transcatheter aortic valve implantation (TAVI) is emerging as a viable alternative in selected BAV anatomies. Initial experiences with first-generation transcatheter heart valves (THVs) showed the feasibility of this technique, but were associated with lower device success rates and higher complications, such as paravalvular leak (PVL) and pacemaker implantation. Advancements in second- and third- generation THVs, together with better pre-procedural imaging assessment and growing operator experience, have significantly enhanced TAVI outcomes in BAV patients, with results now comparable to those seen in tricuspid aortic valves (TAVs). Proper patient selection, pre-procedural sizing, and device implantation are key to improving TAVI success in BAV. Recent registry data on contemporary THV platforms demonstrate improved procedural success, hemodynamic performance, and the safety of TAVI in BAV. However, higher rates of PVL, pacemaker implantation, and strokes remain concerns. Ongoing advancements in THV design and procedural techniques will further enhance outcomes for this challenging population. Up to the present, there are no dedicated THVs for BAV, but the latest-generation THVs offer promising results. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Transcatheter Aortic Valve Replacement)
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15 pages, 1467 KiB  
Review
Redo-Transcatheter Aortic Valve Replacement Procedural Optimization and Patient Selection: From Bench to Clinical Practice
by Ruxandra I. Sava, Philippe Garot, Hakim Benamer, Emmanuel Gall, Théo Pezel, Morad Djebbar, Neila Sayah, David Meier, Georgios Tzimas, Jérôme Garot, Florence Leclercq and Mariama Akodad
J. Clin. Med. 2025, 14(8), 2770; https://doi.org/10.3390/jcm14082770 - 17 Apr 2025
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Abstract
With recent guidelines expanding transcatheter aortic valve replacement (TAVR) to younger patients, indications for redo-TAVR will also likely increase. When compared with TAVR, redo-TAVR is a rare and novel procedure. Current clinical data derived from registries suggest excellent safety, with low rates of [...] Read more.
With recent guidelines expanding transcatheter aortic valve replacement (TAVR) to younger patients, indications for redo-TAVR will also likely increase. When compared with TAVR, redo-TAVR is a rare and novel procedure. Current clinical data derived from registries suggest excellent safety, with low rates of 30-day and 1-year mortality following redo-TAVR. Proper understanding of data from bench studies regarding optimal valve configurations, of patient anatomy and of the technical properties of transcatheter heart valves (THV) is essential for patient selection and procedural success. Lifetime management of redo-TAVR should start before the index procedure, as the choice of the index THV has a major impact on the feasibility of redo-TAVR. Procedural optimization by adequate valve sizing, commissural alignment and adequate implant depth of both index and redo-THV are critical determinants of optimal hemodynamics for maximized valve longevity, as well as lifelong coronary access. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Transcatheter Aortic Valve Replacement)
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