Table 5 Technical specifications of the Edwards SAPIEN valve, the CoreValve system, and the valve Boston’s SADRA Edwards SAPIEN Medtronic CoreValve Boston’s SADRA valve Valve Balloon-expandable, tubular, Self-expanding 50mm Braided Nitinol specifications slotted, stainless steel stent nitinol frame sewn to Stent with radial with an attached bovine three porcine pericardial expansion as pericardial trileaflet valve leaflets; prosthesis has frame shortens. and fabric sealing cuff three separate structural elements (inlet, middle and outlet) Delivery Valve is mechanically Valves are manually Valves are method crimped onto a balloon crimped onto the loaded onto the catheter immediately prior delivery system and delivery system implantation then covered by outer and then sheath covered by outer sheath Rapid To stabilise the prosthesis Used to stabilise the Used To ventricular during balloon expansion, prosthesis during stabilise the pacing rapid pacing needed (160 - deployment (rapid prosthesis requirement 220 beats/min) pacing 160-220 during beats/min) deployment (rapid pacing 160-220 beats/min). Delivery 22F (7.3mm) and 24F 18F (6mm) 18F (6mm) sheath size (8mm); 18F (6mm) Methods of Antegrade (Transapical) &, Retrograde Retrograde deployment Retrograde (Transfemoral) (transfemoral and (Transfemoral) subclavian) Potential Discrete height does not Self-expanding Enables device advantages impinge on conductive deployment repositioning or system. retrieval prior to Design modelled on complete traditional heart valve deployment of manufacturing materials and the valve. techniques Adaptive seal. Prosthesis can be if under-deployed initially Source: Table 2, p521 () Rural access Considering the institutional requirements to perform TAVI, patients from rural and remote areas will have to travel to sites where TAVI can be performed. Frequency of use The patient is not expected to undergo another TAVI during their lifetime.
Table 5 Technical specifications of the Edwards SAPIEN valve, the CoreValve system, and the Boston’s SADRA valve Edwards SAPIEN Medtronic CoreValve Boston’s SADRA valve Valve specifications Balloon-expandable, tubular, slotted, stainless steel stent with an attached bovine pericardial trileaflet valve and fabric sealing cuff Self-expanding 50mm nitinol frame sewn to three porcine pericardial leaflets; prosthesis has three separate structural elements (inlet, middle and outlet) Braided Nitinol Stent with radial expansion as frame shortens. Delivery method Valve is mechanically crimped onto a balloon catheter immediately prior implantation Valves are manually crimped onto the delivery system and then covered by outer sheath Valves are loaded onto the delivery system and then covered by outer sheath Rapid ventricular pacing requirement To stabilise the prosthesis during balloon expansion, rapid pacing needed (160 - 220 beats/min) Used to stabilise the prosthesis during deployment (rapid pacing 160-220 beats/min) Used To stabilise the prosthesis during deployment (rapid pacing 160-220 beats/min). Delivery sheath size 22F (7.3mm) and 24F (8mm); 18F (6mm) 18F (6mm) 18F (6mm) Methods of deployment Antegrade (Transapical) &, Retrograde (Transfemoral) Retrograde (transfemoral and subclavian) Retrograde (Transfemoral) Potential advantages Discrete height does not impinge on conductive system. Design modelled on traditional heart valve manufacturing materials and techniques Prosthesis can be if under-deployed initially Self-expanding deployment Enables device repositioning or retrieval prior to complete deployment of the valve. Adaptive seal. Source: Table 2, p521 () Rural access Considering the institutional requirements to perform TAVI, patients from rural and remote areas will have to travel to sites where TAVI can be performed. Frequency of use The patient is not expected to undergo another TAVI during their lifetime.