Transcatheter Aortic Valve Durability: Focus on Structural Valve Deterioration

Transcatheter aortic valve replacement has emerged as a valuable alternative to surgical aortic valve replacement in patients with severe aortic stenosis. Given the expansion of transcatheter aortic valve replacement to lower‐risk and younger populations with longer life expectancy, the durability o...

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Main Authors: Antonin Trimaille, Adrien Carmona, Sandy Hmadeh, Dinh Phi Truong, Benjamin Marchandot, Shinnosuke Kikuchi, Kensuke Matsushita, Patrick Ohlmann, Valérie Schini‐Kerth, Josep Rodés‐Cabau, Philippe Pibarot, Olivier Morel
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.125.041505
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author Antonin Trimaille
Adrien Carmona
Sandy Hmadeh
Dinh Phi Truong
Benjamin Marchandot
Shinnosuke Kikuchi
Kensuke Matsushita
Patrick Ohlmann
Valérie Schini‐Kerth
Josep Rodés‐Cabau
Philippe Pibarot
Olivier Morel
author_facet Antonin Trimaille
Adrien Carmona
Sandy Hmadeh
Dinh Phi Truong
Benjamin Marchandot
Shinnosuke Kikuchi
Kensuke Matsushita
Patrick Ohlmann
Valérie Schini‐Kerth
Josep Rodés‐Cabau
Philippe Pibarot
Olivier Morel
author_sort Antonin Trimaille
collection DOAJ
description Transcatheter aortic valve replacement has emerged as a valuable alternative to surgical aortic valve replacement in patients with severe aortic stenosis. Given the expansion of transcatheter aortic valve replacement to lower‐risk and younger populations with longer life expectancy, the durability of transcatheter heart valves (THVs) has become an important issue that may impact cardiovascular outcomes. THVs share similarities with surgical valves but have unique features, including a trend to larger effective orifice area and less prosthesis–patient mismatch, interactions with the native valve, and crimping process, that may all potentially influence a THV's life span. Multiple mechanisms may lead to bioprosthetic valve dysfunction, including structural valve deterioration, thrombosis, endocarditis, and nonstructural valve deterioration. With an incidence of up to 12.3% 5 years after transcatheter aortic valve replacement, structural valve deterioration represents the ultimate consequence of fibrotic remodeling and calcification within the bioprosthesis, driven by thrombotic and inflammatory processes involving the native aortic valve and influenced by patient and procedural factors. Understanding these mechanisms is crucial for improving THV durability.
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series Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
spelling doaj-art-bf47dfc70b4d42148d6d5852d27e2d462025-08-20T03:58:49ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-07-01141310.1161/JAHA.125.041505Transcatheter Aortic Valve Durability: Focus on Structural Valve DeteriorationAntonin Trimaille0Adrien Carmona1Sandy Hmadeh2Dinh Phi Truong3Benjamin Marchandot4Shinnosuke Kikuchi5Kensuke Matsushita6Patrick Ohlmann7Valérie Schini‐Kerth8Josep Rodés‐Cabau9Philippe Pibarot10Olivier Morel11Department of Cardiovascular Medicine, Nouvel Hôpital Civil Strasbourg University Hospital Strasbourg FranceDepartment of Cardiovascular Medicine, Nouvel Hôpital Civil Strasbourg University Hospital Strasbourg FranceUR 3074, Translational Cardiovascular Medicine, CRBS University of Strasbourg Strasbourg FranceHanoï Medical University Hanoï VietnamDepartment of Cardiovascular Medicine, Nouvel Hôpital Civil Strasbourg University Hospital Strasbourg FranceDepartment of Cardiovascular Medicine, Nouvel Hôpital Civil Strasbourg University Hospital Strasbourg FranceDepartment of Cardiovascular Medicine, Nouvel Hôpital Civil Strasbourg University Hospital Strasbourg FranceDepartment of Cardiovascular Medicine, Nouvel Hôpital Civil Strasbourg University Hospital Strasbourg FranceUR 3074, Translational Cardiovascular Medicine, CRBS University of Strasbourg Strasbourg FranceQuébec Heart and Lung Institute Laval University Québec City QC CanadaQuébec Heart and Lung Institute Laval University Québec City QC CanadaDepartment of Cardiovascular Medicine, Nouvel Hôpital Civil Strasbourg University Hospital Strasbourg FranceTranscatheter aortic valve replacement has emerged as a valuable alternative to surgical aortic valve replacement in patients with severe aortic stenosis. Given the expansion of transcatheter aortic valve replacement to lower‐risk and younger populations with longer life expectancy, the durability of transcatheter heart valves (THVs) has become an important issue that may impact cardiovascular outcomes. THVs share similarities with surgical valves but have unique features, including a trend to larger effective orifice area and less prosthesis–patient mismatch, interactions with the native valve, and crimping process, that may all potentially influence a THV's life span. Multiple mechanisms may lead to bioprosthetic valve dysfunction, including structural valve deterioration, thrombosis, endocarditis, and nonstructural valve deterioration. With an incidence of up to 12.3% 5 years after transcatheter aortic valve replacement, structural valve deterioration represents the ultimate consequence of fibrotic remodeling and calcification within the bioprosthesis, driven by thrombotic and inflammatory processes involving the native aortic valve and influenced by patient and procedural factors. Understanding these mechanisms is crucial for improving THV durability.https://www.ahajournals.org/doi/10.1161/JAHA.125.041505bioprosthetic valve failuredurabilitystructural valve deteriorationtranscatheter aortic valve replacementtranscatheter heart valve
spellingShingle Antonin Trimaille
Adrien Carmona
Sandy Hmadeh
Dinh Phi Truong
Benjamin Marchandot
Shinnosuke Kikuchi
Kensuke Matsushita
Patrick Ohlmann
Valérie Schini‐Kerth
Josep Rodés‐Cabau
Philippe Pibarot
Olivier Morel
Transcatheter Aortic Valve Durability: Focus on Structural Valve Deterioration
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
bioprosthetic valve failure
durability
structural valve deterioration
transcatheter aortic valve replacement
transcatheter heart valve
title Transcatheter Aortic Valve Durability: Focus on Structural Valve Deterioration
title_full Transcatheter Aortic Valve Durability: Focus on Structural Valve Deterioration
title_fullStr Transcatheter Aortic Valve Durability: Focus on Structural Valve Deterioration
title_full_unstemmed Transcatheter Aortic Valve Durability: Focus on Structural Valve Deterioration
title_short Transcatheter Aortic Valve Durability: Focus on Structural Valve Deterioration
title_sort transcatheter aortic valve durability focus on structural valve deterioration
topic bioprosthetic valve failure
durability
structural valve deterioration
transcatheter aortic valve replacement
transcatheter heart valve
url https://www.ahajournals.org/doi/10.1161/JAHA.125.041505
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