Percutaneous Treatment Of Valvular Heart Diseases

REVIEW, 11 November 2009, VOL I ISSUE I, ISSN 1756-0993
doi: 10.5083/ejcm.20424884.14 , Cite or Link Using DOI
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Aylin Yildirir, MD, FESC

In the field of cardiovascular medicine, valvular heart disease continues to be an important health problem. Increased incidence of degenerative valve disease due to longer life expectancy is the main reason for the high prevalence in developing countries, aortic stenosis (AS) and mitral regurgitation (MR) accounting for the majority of the patients. Percutaneous aortic and mitral valve procedures are promising strategies in the treatment of patients with valvular heart disease. The success of percutaneous valve procedures depends on appropriate selection of patients for a particular device and accurate visualisation of the native valve, the prosthesis or device and their relationship before, during and after the procedure. While edge-to-edge repair is appropriate for patients with MR related to leaflet prolapse, the coronary sinus annuloplasty is more suitable for patients with MR secondary to annulus dilatation.

Careful screening of vascular access is very important in patients referred for percutaneous aortic valve replacement. Extensive calcifications and tortuosity of the femoral artery and aorta may hamper positioning of aortic prosthesis; therefore a transapical approach should be considered for these patients. In conclusion, percutaneous valve treatment is an evolving field. Improvements in percutaneous valve substitutes and further development of delivery systems ensuring safe implantation of devices may overcome some of the procedural difficulties in the future.

Correspondence to:
Aylin Yıldırır, MD, FESC, Professor of Cardiology Baskent University, School of Medicine Ankara, Turkey. ayliny@baskent-ank.edu

Keywords:

valvular heart disease, percutaneous treatment of mitral valve diseases, aortic stenosis, mitral regurgitation