De Biase, Chiara (2020) New perspectives for transcatheter aortic valve implantation: the "coup d'essai" of bicuspid aortic valves. [Tesi di dottorato]

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Abstract

Outline of the thesis The thesis is divided in four parts. Part I: Aortic valve disease and innovation in percutaneous treatment by transcatheter aortic valve implantation. In this first section of the thesis we present some research projects published in the field of transcatheter aortic valve replacement in general population, describing the progress of this percutaneous technique during the past years until nowadays practice. In this section there are some considerations about TAVI in particular scenarios and procedural settings requiring dedicated technical adjustments. Part II: TAVI in a complex anatomical setting: Bicuspid Aortic Valve management and percutaneous treatment. In this second section we collected research papers focused on the challenging anatomy of bicuspid aortic valves (BAV) undergoing TAVI treatment for aortic stenosis (AS). In contemporary TAVI practice BAV anatomy still represents a challenge for percutaneous treatment. This section is the real focus of the three years of PhD research, since the complexity of the topic and the time required for data collection and analysis. Moreover, this part represents the result of an International collaboration and knowledge sharing among renowned centres for the percutaneous treatment of aortic disease. Part III: Imaging for TAVI in Bicuspid Aortic Valve. This section includes research papers investigating the role of imaging, in particular of multi-sliced computed tomography (MSCT), in BAV patients undergoing TAVI procedure, considering the lack of standardized protocols for sizing and device choice in this complex aortic valve anatomy. Part IV: Discussion and Conclusions. The last part of the thesis is a discussion of the presented topics with some conclusions.

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