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Ann Thorac Surg 2009;88:2071-2072. doi:10.1016/j.athoracsur.2009.06.100
© 2009 The Society of Thoracic Surgeons
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Correspondence

Transcatheter Aortic Valve Therapy Is Not Aortic Valve Replacement

Michele Portoghese, MD

Division of Cardiac Surgery, "SS Annunziata Hospital", via De Nicola, Sassari, 07100 Italy

(Email: michele.portoghese{at}virgilio.it).

To the Editor:

I read with interest the increasing number of scientific articles involving transcatheter aortic valve replacement [1, 2].

The meaning of the term "replacement" is to substitute something with something else [3]. Yet, at present, the only way to substitute a stenotic aortic valve is to take away the calcific or fibrotic tissue and put in a new prosthetic valve, which is a surgical (traditional or minimally invasive) approach.

I believe this is not merely a semantic question. As a matter of fact, the presence of the native valve left in situ could be one of the major potential issues affecting the outcome of the transcatheter procedures: peri-procedural risk of stroke and perivalvular leak or infection could be highly related to this aspect.

For these reasons, I believe that the transcatheter procedure could be defined as "implant, insertion, overlapping or therapy," but not as aortic valve replacement.


   References
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 References
 

  1. Brown Ml, Schaff HV, Sarano ME, et al. Is the European system for cardiac operative risk evaluation model valid for estimating the operative risk of patients considered for percutaneous aortic valve replacement? J Thorac Cardiovasc Surg 2008;136:566-571.[Abstract/Free Full Text]
  2. Webb JG, Pasupati S, Humpries K, et al. Percutaneous transarterial aortic valve replacement in selected high-risk patients with aortic stenosis Circulation 2007;116:755-763.[Abstract/Free Full Text]
  3. Compact Oxford English Dictionary of Current English. 3rd ed.. New York, NY: Oxford University Press; 2008(online).




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