Valve Replacement

Valve replacement
ICD-9-CM	V43.3
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Short description: Replacement of one or more of the heart valves

Valve replacement surgery is the replacement of one or more of the heart valves with either an artificial heart valve or a bioprosthesis (homograft from human tissue or xenograft e.g. from pig). It is an alternative to valve repair.

Procedures

There are four procedures

Aortic valve replacement
Mitral valve replacement
Tricuspid valve replacement
Pulmonary valve replacement

Current aortic valve replacement approaches include closed heart surgery, Very invasive cardiac surgery (VICS) and Very invasive, Scapulae-based aortic valve replacement.

Catheter replacement of the aortic valve (called trans-aortic valve replacement or implementation [TAVR or TAVI]) is a minimally invasive option for those suffering from aortic valve stenosis. TAVR is commonly performed by guiding a catheter from the groin to the narrowed valve via the aorta using realtime x-ray technology. A metal stent containing a valve is then deployed using a balloon to press the stent into the valve in effect opening the stenosed (or narrowed) valve and lodging the stent in place. The procedure was first approved in the United States in November 2011 ^[1] as an alternative for people deemed a poor candidate for open approach replacement; however, TAVR has been successfully implemented into practice in other countries prior to 2011.^[1]

Medical uses

In those between 50 and 70 years of age bioprosthetic and mechanical aortic valves have similar overall outcomes with respect to stroke and survival.^[2]

References

↑ ^1.0 ^1.1 "FDA-approved transcatheter approach offers life-extending valve replacement for inoperable patients". Stanford School of Medicine. http://medicalstaff.stanfordhospital.org/ms/medstaffupdate/articles/201208_FDA_Approved_Transcatheter_Approach.html.
↑ Chiang, Yuting P.; Chikwe, Joanna; Moskowitz, Alan J.; Itagaki, Shinobu; Adams, David H.; Egorova, Natalia N. (1 October 2014). "Survival and Long-term Outcomes Following Bioprosthetic vs Mechanical Aortic Valve Replacement in Patients Aged 50 to 69 Years". JAMA 312 (13): 1323–9. doi:10.1001/jama.2014.12679. PMID 25268439.

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[medicalstaff-1] 1.0 ^1.1 "FDA-approved transcatheter approach offers life-extending valve replacement for inoperable patients". Stanford School of Medicine. http://medicalstaff.stanfordhospital.org/ms/medstaffupdate/articles/201208_FDA_Approved_Transcatheter_Approach.html.

[2] Chiang, Yuting P.; Chikwe, Joanna; Moskowitz, Alan J.; Itagaki, Shinobu; Adams, David H.; Egorova, Natalia N. (1 October 2014). "Survival and Long-term Outcomes Following Bioprosthetic vs Mechanical Aortic Valve Replacement in Patients Aged 50 to 69 Years". JAMA 312 (13): 1323–9. doi:10.1001/jama.2014.12679. PMID 25268439.