Feature | March 19, 2014

First Human Totally Endoscopic Aortic Valve Replacements (TEAVR) Reported

Surgeons Describe First TEAVR Procedures

March 19, 2014 — Surgeons in France have successfully replaced the aortic valve in two patients without opening the chest during surgery. The procedure, using totally endoscopic aortic valve replacement (TEAVR), shows potential for improving quality of life of heart patients by offering significantly reduced chest trauma. It is described in The Journal of Thoracic and Cardiovascular Surgery.

TEAVR had not been feasible previously because of the currently available designs of stented tissue valves. The recent advent of sutureless bioprostheses mounted on a compressible self-expanding nitinol (nickel titanium) stent, was one of the key factors enabling the surgical team to perform this procedure. Implantation required less than 45 minutes in either patient. Sutureless substitutes are not yet available for the other cardiac valves, like the mitral valve.

“In our institution, we began by adopting the mini-sternotomy technique, involving a small incision through the sternum, as routine. We then transitioned to the right mini-thoracotomy approach, involving a small incision through the thorax, first under direct view, then with an endoscopic camera. Finally we adopted a totally endoscopic technique,” said lead author Marco Vola, M.D., Ph.D, of the Department of Cardiovascular Surgery, Centre Hospitalier Universitaire de Saint-Etienne, France.

“It is important to note that when performing TEAVR, a quick and safe conversion to mini-thoracotomy under direct view can be made if circumstances demand. This would still offer significantly reduced chest trauma,” he said.

In other fields, totally endoscopic surgery involved longer clamping and cardiopulmonary bypass (CPB) times during the learning curve. The investigators believe that clamping and CPB times were acceptable and that the learning curve could be shorter than reported for totally endoscopic coronary artery bypass grafting.

Enhancements such as endoscopic sizers, dedicated instruments for decalcification, and second-generation sutureless bioprostheses to simplify implantation, could improve the procedure further, Vola and his colleagues comment. Last but not least, surgical robots may offer additional benefits.

“These first procedures show that totally endoscopic sutureless aortic valve replacement is technically feasible. Further clinical experience and technical development are necessary to shorten operation times and to assess further the potential postoperative benefits of TEAVR,” said Vola.

For more information: www.jtcvsonline.org

Related Content

TeleHealthRobotics, Tele-Robotic Ultrasound, TRUDI, robotic ultrasound

The Tele-Robotic Ultrasound for Distance Imaging (TRUDI) system uses a robotic arm so a remote sonographer can control the echo probe without the need for them to be in the same room or even be in the hospital during an exam or procedure. 

News | Cardiovascular Ultrasound| June 09, 2016
June 9, 2016 — The American Society of Echocardiography (ASE) will host Echovation Challenge 2016, a competition for
News | Stem Cell Therapies| May 26, 2016
May 26, 2016 — Ligand Pharmaceuticals Inc.
Edwards, Sapien 3, SOURCE 3 Registry, EuroPCR 2016
News | Heart Valve Technology| May 24, 2016
Thirty-day data from the European post-approval study of the Edwards Sapien 3 transcatheter aortic heart valve...
CardiAQ, Neovasc, lawsuit, TMVR
News | Business| May 24, 2016
Edwards Lifesciences Corp. announced that a federal jury in Boston returned a verdict in favor of CardiAQ in a lawsuit...
Mitralign, Series E funding, Trialign, MPAS
News | Heart Valve Technology| May 23, 2016
Mitralign Inc. announced it has raised $39.8 million to date in a Series E equity round of financing.
TAVR outcomes, aortic valve gradient, JACC study
News | Heart Valve Technology| May 23, 2016
Patients with a combination of left ventricular dysfunction and low aortic valve gradient have higher mortality rates...
Direct Flow Medical, TAVR device, DISCOVER trial, three-year results, EuroPCR 2016
News | Heart Valve Technology| May 20, 2016
Direct Flow Medical Inc. presented three-year results from its prospective, multicenter DISCOVER Trial at the EuroPCR...
RDAVR, aortic valve replacement, Edwards Intuity, TRANSFORM Trial, AATS meeting
News | Heart Valve Technology| May 18, 2016
The TRANSFORM trial was designed to evaluate the safety and performance of an investigational rapid deployment aortic...
NeoChord, DS1000 System, FDA approval, U.S. pivotal trial
News | Heart Valve Technology| May 17, 2016
NeoChord Inc. announced it has received Investigational Device Exemption (IDE) approval from the U.S. Food and Drug...
4Tech Inc., TriCinch transcatheter tricuspid valve repair device, Jean-Claude Laborde

Image courtesy of 4Tech Inc.

News | Heart Valve Technology| May 16, 2016
4Tech Inc. announced its partnership with Jean-Claude Laborde, M.D., as a research and development (R&D) and...
Overlay Init