Top 5 Technologies used for Aortic Valve Replacement

Aortic valve diseases such as stenosis or regurgitation are one of the major reasons to undergo aortic valve replacement or repair surgery which affects millions of people.

However, treatment options were limited but now, the latest advancements in technology, surgical techniques, and artificial intelligence have revolutionized aortic valve replacements.

So, if you want to learn about these technologies and their benefits then this article will help you to clear all your doubts, so read it carefully.

Understanding Aortic Valve Disease

Aortic valve disease is a group of conditions that affect your valve and prevent it from working as it should. However, it’s a door that manages blood flow from your heart to the rest of your body. 

Additionally, your aortic valve closes and opens each time your heart beats and it should open widely to create enough space for blood flow to pass through. However, there are two main types of aortic valve diseases which include:

• Aortic valve stenosis

It's a condition in which the aortic valve which regulates blood flow from the heart to the aorta gets narrowed and makes it harder for the heart to pump blood.

• Aortic valve regurgitation

It is also known as insufficiency which occurs when the aortic valve doesn’t close completely and causes blood leakage backward into the heart.

However, it's information to understand that you could have one of both types of aortic valve diseases but you didn’t realize it yet because the symptoms often don’t show up until after the disease has progressed.

Why Might I Need Aortic Valve Replacement?

Aortic valve repair or replacement surgery is performed to correct or treat the problems caused by 1 of the heart valve diseases. However, if your valve is damaged or diseased then you may experience these given symptoms:

• Dizziness
• Chest pain
• Breathing problems
• Palpitations
• Swelling in feet, ankles, or belly
• Rapid weight gain

Yet, there might be other reasons why your doctor recommends heart valve repair or replacement surgery. 

Here are the Top 5 Technologies Used for Aortic Valve Replacement

Transcatheter Aortic Valve Replacement (TAVR)

TAVR is a medical procedure that aims to replace the aortic valve without open heart surgery. However, the common reason for TAVR is aortic valve stenosis which is the narrowing of the valve or the surrounding area. Yet, it can be caused by age-related wear or tear, or other health conditions such as rheumatic heart disease or bicuspid aortic valve.

Benefits of TAVR Over Traditional Surgery

• It's a minimally invasive approach that doesn't require open heart surgery.
• It offers faster recovery and patients can go home within 48 hours.
• It lowers the risk of complications like bleeding, infection, or stroke.

Furthermore, TAVR was initially approved only for high-risk patients but because of its success and advancements in valve technology, it's now widely available for lower-risk patients as well.

Next-Generation Aortic Valves

While TAVR has become a more popular and effective option, several challenges persist with the first-generation devices, and to address these concerns, several second-generation TAVR devices have been developed. Here are the detailed information about new devices that are becoming a part of modern clinical practice, include:

Medtronic Evolut R

This device improves the Medtronic CoreValve with features such as better valve positioning, reduced paravalvular regurgitation, and also improved comfort in the aortic root.

Medtronic Engager

It is designed for better anatomical fit which helps to reduce the risk of coronary obstruction and paravalvular regurgitation. Additionally, it uses a self-expanding nitinol frame and features a delivery system for controlled deployment through transapical or direct aortic routes.

Boston Lotus

It uses a braided nitinol wire and provides a fully repositionable and retrievable design. It provides an adaptive seal that aims to improve sealing and minimize paravalvular leakage. 

Edwards SAPIEN 3

This device aims to improve the previous generation of SAPIEN with a modified design that reduces its profile improves the valve positioning and also addresses paravalvuar regurgitation.

Direct Flow Medical

This valve uses a non-metallic, inflatable structure, and offers accurate deployment with enhanced delivery system flexibility. 

St. Jude Portico

It's a self-expanding valve with a unique sealing cuff design which helps to improve sealing and reduce paravalvular regurgitation.

Symetis ACURATE

It refers to a line of transcatheter arctic valve prostheses which is specially designed for treating aortic stenosis with the ACURATE TA being designed for transapical access and the ACURATE neo for both transapical and transfemoral access.

JenaValve

This valve system is unique for its mechanism to actively secure the valve to the native leaflets using feelers which reduce radical forces in the sensitive structure.

Benefits of Next-Generation Aortic Valves:

• Its enhanced design features and delivery system provide more accurate placement which reduces the risk of valve malpositioning.
• It reduces the risk of paravalvular regurgitation, coronary obstruction, and conduction disturbances.

Robotic-Assisted Aortic Valve Surgery

Robotic-assisted heart valve repair is a minimally invasive approach which means the surgery uses smaller incisions than a traditional open surgery, additionally, along with smaller cuts surgeons use robotic instruments to help fix the valve.

Benefits of Robotic-Assisted Aortic Valve Surgery

• It's a minimally invasive technique that aims to reduce surgical trauma.
• It offers more precise valve replacement and improves long-term function.
• It helps to lower the risk of complications and provides shorter hospital stays.

Stem Cell for Heart Valve Regeneration

Stem cell therapy for heart valve regeneration involves using a stem cell particularly mesenchymal stem cells to generate new heart valve tissue which provides a potential alternative to traditional valve replacement or repair.

Benefits of Stem Cell for Heart Valve Regeneration

• The engineered heart valve works more like a natural valve which avoids the limitations of traditional prostheses.
• A tissue-engineered valve might be more durable and it requires less frequent replacement compared to current options.

Tissue-Engineered Heart Valves

It's an innovative approach that aims to treat valvular heart disease by creating living, functional heart valves that mimic the natural behavior of native heart valves. Additionally, these valves are designed to respond to growth and physiological forces in the same way as the natural valve does.

However, there are two main types of strategies explored in tissue-engineering heart valves which include regeneration which involves implanting a resorbable matrix that remodels the body, and repopulation which uses pig-derived aortic valve that is stripped from animal cells to repopulate the acellular matrix to create a living tissue that already has the necessary microstructure for proper valve function and durability.

Yet, with various setbacks of these innovative approaches here are some potential benefits as well.

Benefits of Tissue-Engineered Heart Valve

• By using the patient’s own cells, these valves might be less likely to attack immune rejection or complications as compared to mechanical or animal tissue valves.
• Unlike mechanical or biological valves, tissue-engineered valves might have the ability to grow and adapt to the patient’s needs over time which makes them valuable for pediatric patients or patients with severe heart valve diseases.
• Mechanical valves often require blood thinners to prevent blood clots, but with tissue-engineered valves, it reduce the neeed for medication.