The nomenclature for such devices includes transcatheter heart valve replacement (THVR) and percutaneous heart valve replacement. In this instance, ‘percutaneous’ is used interchangeably with ‘transcatheter’. For the sake of this report, these devices will be referred to as transcatheter heart valve replacement devices. The industry standard is to define these products further by denoting the specific heart valve for which the device is indicated. Examples of this would be transcatheter aortic valve replacement (TAVR), transcatheter mitral valve replacement (TMVR) devices and transcatheter pulmonary valve replacement (TPVR) devices.
In a transcatheter heart valve replacement procedure, a collapsible replacement valve is delivered to the damaged valve via a balloon catheter. The balloon catheter then inflates to expand the replacement within the old valve, pushing the old valve leaflets out of the way and allowing the replacement valve to regulate blood flow. The balloon catheter is then deflated and removed.
The primary method for treating heart valve conditions is through open surgery to place a replacement valve. Biological tissue valves can be allografts (provided by deceased donors), xenografts (bovine or porcine valves) or autografts (using the patient’s own pulmonary valve, which in turn, needs to be replaced). Tissue valves have been gaining popularity over the alternative mechanical valves because tissue valves are much more biocompatible and do not require lifelong treatment with anti-coagulant medication. However, mechanical valves are more durable and are designed to last for 20-30 years, whereas bioprosthetic valves last 10-15 years. Some patients with heart valve problems are poor candidates for valve replacement surgery because they may be too ill to undergo such an invasive procedure. Therefore, there is a great deal of interest in the development of transcatheter heart valve replacement (THVR) devices.
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TABLE OF CONTENTS I
LIST OF FIGURES XII
LIST OF CHARTS XV
EXECUTIVE SUMMARY 1
U.S. CARDIAC SURGERY AND HEART VALVE DEVICE MARKET OVERVIEW 1
COMPETITIVE ANALYSIS 4
MARKET TRENDS 7
MARKET DEVELOPMENTS 11
PROCEDURE NUMBERS 12
PROCEDURE CODES INVESTIGATED 16
MARKETS INCLUDED 17
KEY REPORT UPDATES 19
VERSION HISTORY 20
RESEARCH METHODOLOGY 21
Step 1: Project Initiation & Team Selection 21
Step 2: Prepare Data Systems and Perform Secondary Research 24
Step 3: Preparation for Interviews & Questionnaire Design 26
Step 4: Performing Primary Research 27
Step 5: Research Analysis: Establishing Baseline Estimates 29
Step 6: Market Forecasts and Analysis 30
Step 7: Identify Strategic Opportunities 32
Step 8: Final Review and Market Release 33
Step 9: Customer Feedback and Market Monitoring 34
DISEASE OVERVIEW 35
2.1 BASIC ANATOMY 35
2.1.11 Coronary Artery Disease 37
2.1.12 Myocardial Infarction 37
2.1.13 Angina Pectoris 38
2.1.14 Heart Valve Disease 39
2.1.15 Congestive Heart Failure 39
PRODUCT PORTFOLIO 41
3.1.1 Tissue Heart Valves 41
3.1.2 Mechanical Tissue Heart Valves 43
3.1.3 Annuloplasty Repair Devices 45
3.1.4 Transcatheter Aortic Valve Replacement Devices 47
3.1.5 Transcatheter Mitral Valve Repair Devices 49
3.1.6 On-Pump Coronary Artery Bypass Devices 50
3.1.7 Off-Pump Coronary Artery Bypass Devices 52
3.1.8 Endoscopic Vessel Harvesting Devices 53
3.1.9 Anastomosis Assist Devices 54
3.1.10 Transmyocardial Revascularization Devices 55
3.1.11 Ventricular Assist Devices 56
3.1.12 Intra-Aortic Balloon Pump Device 57
3.1.13 Temporary Artificial Heart Replacement Device 58
3.1.14 Remote Hemodynamic Monitoring System Devices 59
3.1.15 Patent Foramen Ovale Devices 59
3.1.16 Atrial & Ventricular Septal Defect Device 61
3.1.17 Left Atrial Appendage Closure Device 62
3.1.18 Extracorporeal Membrane Oxygenation Machine 63
3.2 FDA RECALLS 64
3.2.1 MAQUET 64
3.2.2 Medtronic 66
3.2.3 HeartWare Inc 67
3.3 CLINICAL TRIALS 68
3.3.1 Medtronic 68
3.3.2 St. Jude Medical 70
3.3.3 Abiomed 75
3.3.4 Heartware Inc 76
TRANSCATHETER HEART VALVE REPLACEMENT DEVICE MARKET 78
4.1 INTRODUCTION 78
4.2 MARKET ANALYSIS AND FORECAST 80
4.3 DRIVERS AND LIMITERS 83
4.3.1 Market Drivers 83
4.3.2 Market Limiters 84
4.4 COMPETITIVE MARKET SHARE ANALYSIS 86
4.4.1 Potential Competitors 88
ABBREVIATIONS 89
APPENDIX: COMPANY PRESS RELEASES 92
Chart 1 1: Cardiac Surgery and Heart Valve Devices Market by Segment, U.S., 2014 – 2024 3
Chart 1 2: Cardiac Surgery and Heart Valve Devices Market Overview, U.S., 2017 & 2024 3
Chart 4 1: Transcatheter Heart Valve Replacement Device Market, U.S., 2014 – 2024 82
Chart 4 2: Leading Competitors, Transcatheter Heart Valve Replacement Device Market, U.S., 2017 87
Edwards Lifesciences
St. Jude Medical
Medtronic
Maquet
Abiomed
HeartWare Inc.
Sorin Group
Terumo
Abbott Laboratories
Teleflex Medical
Cardiac Assist
AtriCure
W.L. Gore
SynCardia
Boston Scientific
Cryolife
Others include: Berlin Heart, Cardica, Chase Medical, Genesee Biomedical, Karl Storz, LifeNet Health, Microline Surgical, Novadaq, On-X, Saphena Medical, SentreHeart, Vitalitec, etc.