From an Unfolding Emergency Treatment to a Universal Shift in Therapy: The History and Evolution of the Catheter-Based Treatment of Aortic Valve Stenosis.

Aortic valve stenosis (AVS) is the most frequent valvular heart disease in industrialized countries, presenting with very high mortality if left untreated. While drug treatment can sometimes alleviate symptoms, it fails to stop progression or cure the underlying disease. Until the first decade of this millennium, surgical aortic valve replacement (SAVR) remained the only available therapy option with a positive impact on mortality and morbidity.

Transcatheter aortic valve implantation with a mechanically expandable prosthesis: a learning experience for permanent pacemaker implantation rate reduction.

Background: Permanent pacemaker implantation (PPMI) after transcatheter aortic valve implantation (TAVI) remains an issue open for criticism. Aim of this study is to investigate a strategy to reduce PPMI rate after TAVI in general and more specifically after implantation of the LOTUS prosthesis.

Methods: Through our learning curve, we have developed a structured protocol to reduce PPMI rate.

Introducing transcatheter aortic valve implantation with a new generation prosthesis: Institutional learning curve and effects on acute outcomes.

Objectives: We present our single-centre experience with the direct flow medical (DFM) trans-catheter aortic valve implantation (TAVI) prosthesis addressing the impact of learning curve upon outcomes.

Background: The DFM has been recently introduced for TAVI. The prosthesis presents original design and implantation features.

Trans-catheter aortic valve implantation with the direct flow medical prosthesis: Single center short-term clinical and echocardiographic outcomes.

Objectives: To analyze our single center experience with the Direct Flow Medical (DFM).

Background: The DFM has been recently introduced to the market and large real world experiences are lacking.

Methods: A total of 126 patients with severe aortic valve stenosis (AVS) were treated by the same team from March 2013 to May 2015.

Transcatheter aortic valve implantation with the direct flow medical prosthesis: Impact of native aortic valve calcification degree on outcomes.

Objectives: We present our single center experience with the direct flow medical (DFM) prosthesis addressing the impact of native aortic valve (AV) calcification degree on outcomes.

Background: The DFM® has been introduced for transcatheter aortic valve implantation (TAVI). The valve has a nonmetallic and inflatable support structure.

Transcatheter aortic valve implantation in obese patients: Overcoming technical challenges and maintaining adequate hemodynamic performance using new generation prostheses.

Background: Second-generation TAVI prostheses may enhance the procedure reducing operative time and complications rate, maintaining adequate valve hemodynamic performance. We present our results with 2 new generation trans-catheter aortic valve (TAVI) prostheses in obese patients.

Methods: A series of 172 patients underwent trans-femoral TAVI with new generation prostheses (Direct Flow Medical, DFM®, and LOTUS®).

Treatment of secondary mitral valve regurgitation: why we need combined and evolving percutaneous strategies to tackle this moving target.

Secondary mitral regurgitation (MR) has a complex pathophysiology that includes global or segmental left ventricular (LV) motion abnormalities (of non-ischaemic or ischaemic origin) leading to impaired leaflet coaptation of a normally structured mitral valve (MV). In this context, the LV functional and geometrical changes result in MV leaflet tethering, MV annulus flattening and the decrement of systolic MV closing forces. In light of its complexity, management of secondary MR remains a challenge.

Transcatheter, inflatable, and fully repositionable aortic valve: Preliminary results using a modified implantation technique.

Objectives: We present our experience with an inflatable, non-metallic, fully retrievable, and repositionable transcatheter aortic valve [Direct Flow® Medical (DFM)] focusing on technical features adopted during implantation.

Background: Implantation techniques of new generation percutaneous aortic valves are still developing and with experience implementations are described.

Methods: The "low pressure" (initial valve inflation at 4 ATM, lower than the recommended 12 ATM) and the "alternate aortic curve" techniques (initial valve pulling either from the wire running on the side of the inner or from the one on the outer aortic curve) are part of our modified protocol for DFM® implantation.