Transcatheter Valve Repair discusses all aspects related to percutaneous and established valve repair methods. The book is divided into few major sections covering all four valves and other topics. Each section contains several chapters discussing everything related to that valve. Beginning with the pulmonary valve, since it was the first valve to be tackled in the catheterization laboratory, and then moving to the aortic, then the mitral and then finally end with the tricuspid valve. 1.5M US citizens alone have some degree of aortic valve stenosis, with half (750K) requiring aortic valve replacement. Aortic valve replacement, on the whole, is performed by surgeons, requiring bypass machines and technicians, as well as the usual operating team. The operation is expensive and occupies a considerable amount of operating room time. Mostly, the aortic valve is calcified and the usual option available to patients is valve replacement with a variety of choices, ranging from porcine valves to synthetic, for which there are many manufacturers. It should be noted that the aortic valve is the most problematic of valves. Percutaneous procedures are the answer.
The bottom line is that given the growing elderly population, many more patients will require valve repair, thus increasing health care costs with not only surgical operations but also hospitalisation. Percutanous valve repair, whilst requiring a cath lab team, does not involve bypass machines nor extended hospitalisation. Like percutaneous transluminal coronary artery interventions (PTCA) has replaced coronary artery bypass grafts (once the golden standard), and now stenting having replaced PTCA and its balloons. We now see drug eluting stents replacing ordinary stents (though at a much higher cost. There will be a huge movement toward percutanous valve repair, which should presumably cut costs but also morbidity and mortality.
Table of Contents
The Pulmonary Valve. Embryology/Pathology of the pulmonary valve both in stenosis and regurgitation: Pulmonary Regurgitation. Assessment of the pulmonary valve with magnetic resonance imaging. Hemodynamic evaluation of pulmonary valve disease and Indications for repair/replacement of the valve. Hemodynamic Evaluation of Pulmonary Valve Disease:Indications for Repair, Replacement and Valvuloplasty. Impact of emerging technologies in cardiology and Cardiothoracic Surgery- Percutaneous pulmonary valve implantation. Established techniques for repair/replacement of the pulmonic valve:
Small intestinal submucosa-a new generation of valve replacement. Available Transcatheter pulmonary valves: Perventricular Technique with Shelhigh valve. Available transcatheter pulmonary valves- Bonhoeffer valve. Extending the present limitations and indications of percutaneous pulmonary valve replacement to small patients and large ventricular outflow tracts. The Aortic Valve. Embryology/Pathology of the aortic valve in AS and AR. Aortic Stenosis: Pathophysiology, clinical, and echocardiographic manifestations. Hemodynamic Evaluation of aortic valve disease and Indications for repair/replacement. Impact of new percutaneous techniques of aortic valve replacement on cardiology/cardiac surgical practice.
Established Methods of aortic valve repair and replacement. Non-surgical aortic valve replacement: history, present and future perspectives. Clinical Experience with the Percutaneous Heart Valve for treatment of degenerative aortic stenosis. The CoreValve in the Aortic Position. Development of a Nanosynthesized Metallic Percutaneous Aortic Valve. The Mitral Valve. Embryology of the mitral valve and Pathology of mitral valve stenosis, Regurgitation. Mitral valve disease. MRI/CT Scan evaluation of the mitral valve. Invasive Hemodynamics for the assessment of the mitral valve. Impact of emerging percutaneous techniques on Cardiology and cardiac surgical practice: Established methods of surgical mitral valve repair and replacement. Percutaneous leaflet repair for mitral regurgitation using the Evalve edge-to-edge clip technique. Available Transcatheter mitral valve repair techniques. CS method. A Hybrid approach to the mini-invasive replacement of the mitral valve. The Tricuspid Valve. Evaluation of the tricuspid valve using MRI. Hemodynamic evaluation of tricuspid stenosis and regurgitation: Indications for repair and replacement. Established surgical methods for tricuspid valve repair and replacement. Available devices for percutaneous replacement of the tricuspid valve. Tissue Engineering. Different tissues for valves: How to choose the right tissue. Valve Testing. Valve testing: Durability and beyond
"an excellent compilation of a fast and newly developing field. There is liberal use of color illustrations. […] I think cardiologists, both pediatric and adult, and cardiac surgeons will find something of interest in this book. As this field develops and more clinical information becomes available, it is likely that future editions will include more outcomes data and will allow this first-rate book to develop into a classic." Howard C. Herrmann, Circulation, 2006, 114: 12