| Abstract [eng] |
Structural heart disease is a term describing wide range of conditions of which heart valve diseases are the most prevalent. They can be treated either surgically or percutaneously, however, in the recent years there have been an increased number of publications outlining the advantages of minimally invasive approach. The aim of this literature analysis was to discuss the most common heart valve diseases, present transcatheter devices used for their treatment and discuss novelties and innovations for the future approaches. Transcatheter aortic valve implantation is the most popular and developed minimally invasive treatment option for aortic stenosis, demonstrating good clinical outcomes as well as a low incidence of complications. For some time, heavily calcified and occluded peripheral arteries were one of the factors that prevented some patients from getting their stenotic aortic valve replaced via percutaneous route. However, the successful use of intravascular lithotripsy devices to restore the accessibility of these arteries looks promising and may allow for even more patients to be successfully treated. Using older balloon expandable valve models was associated with higher incidence of conduction disturbances and the need to implant a new pacemaker, while patients who received the self-expanding valves were prone to developing higher grade paravalvular leak. However, newer valve models of both types demonstrated improved results. Although golden treatment standard for mitral regurgitation is surgical option, the need for percutaneous interventions is high as well, since around half of these patients are inoperable. Currently, the most developed transcatheter treatment option is edge-to-edge repair, however many more options, such as direct or indirect mitral annuloplasty, are being developed and trialed. |
