What Is Percutaneous Valve Replacement?

Percutaneous aortic valve replacement is a new minimally invasive valve replacement technology developed and adopted. The English name is Percutaneous Aortic Valve Replacement, PAVR.

Percutaneous aortic valve replacement

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Percutaneous aortic valve replacement is a new minimally invasive valve replacement technology developed and adopted. The English name is Percutaneous Aortic Valve Replacement, PAVR.

Chinese name

Percutaneous aortic valve replacement

Foreign name

Percutaneous Aortic Valve Replacement

Abbreviation

PAVR

Nature

Minimally invasive valve replacement

Because valves are not replaced as surgically, they are also known as Transcatheter aortic valve implantation (TVAI) ^[1]

So far, more than 20,000 patients worldwide have received percutaneous aortic valve replacement. The number of cases reported in recent studies is increasing, and the effect of surgery is becoming more and more encouraging. The results of a large-scale published PAVR study show that the success rate of PAVR is very high (between 93.3% and 98.4%), and the 30-day mortality rate is 8.5% -12.7%. Because the high-risk patients were selected, this mortality rate is still acceptable. Common complications include atrioventricular block requiring a pacemaker, stroke, and local vascular complications. Although there are many researches on PAVR abroad and the progress is rapid, China's research in this area started late. Thankfully, on October 3, 2010, Professor Ge Junbo of Zhongshan Hospital Affiliated to Fudan University has successfully completed the first domestic TAVI procedure, setting a precedent for PAVR in China.

PAVR has achieved satisfactory results in clinical applications, but there are still many problems to be solved. Aortic root anatomy is complicated, surgery is difficult, and the incidence of complications such as stroke and slow arrhythmia is still high. The technology has not made the stent valve completely attached to the aorta, and some patients may have a valve. Displacement and severe paravalvular thromboembolism and limited stent life have potential risks. Surgical instruments are expensive and there are no domestic instruments. However, with the advancement of materials engineering and the continuous enrichment and accumulation of doctors' experience in interventions, I believe that some existing technical problems will be continually solved and the interventional treatment of aortic valve disease will continue to develop, even replacing valve replacement surgery as a routine operation Dr. Grube concluded that "the surgical device has been reduced to an 18-F catheter without compromising safety, which has significantly improved the procedure (local vascular complications have been greatly reduced). The procedure is less invasive and requires no ventricular assist devices, General anesthesia and the preparation of surgical incisions have significantly shortened the operation time. The third generation valve enables us to achieve a true percutaneous aortic valve replacement. In the near future, it will change the standard treatment of aortic valve stenosis, especially It is a high-risk surgical procedure for those patients with active severe aortic stenosis.