TAVI has evolved as a routine procedure for high risk patient with severe aortic stenosis. Medtronic CoreValve™ and Edward SAPIEN™ are two classic TAVI systems which have been widely used with accepted results [2,3]. However, these first-generation systems still have specific drawbacks such as highly technique requirements for precise valve positioning, relatively frequent requirement for pace-maker implantation as well as high risk for more than mild degree para-valvular leakage [2,3].
Next-generation transcatheter valves should overcome the known limitations of the currently available TAVI. In this case, we used the brand new J-Valve™ TAVI system. Sharing the similarity with other second-generation TAVI devices with anatomically oriented devices such as Jena-Valve™ and Medtronic Engager Valve™ [4,5], this system is characterized by a unique design U-shape graspers which could be totally released before the valve implantation facilitating intuitive ‘self-positioning’ valve implantation. This unique design could greatly simplify the implantation process and lead to more consistent results, because the operator does not need to actively judge for optimal valve position. Meanwhile, through embracing the native valve leaflets through three U shape graspers, J-Valve™ system has the advantage of achieving better anchoring, less risk for coronary obstruction from native cusp calcification, as well as less risk of conduction block (extra-axial fixation and subsequent less radial expansion forces).
Also different from other second-generation TAVI devices, U-Shape graspers of J-Valve™ system could increase the interface between aortic valve leaflets and valve prosthesis which would provide more anchorage force (axial fixation) after valve deployment. In addition, the unique two stage releasing design of this system (graspers totally release first and followed by the valve release) could also largely facilitate accurate adjusting the position of the graspers before valve deployment. Furthermore, compared with single arm feeler device of Jena-valve™, this U-shape grasper could also minimize the risk of native valve perforation.