Table 1.

Innovative Aortic Valve Therapeutic Approaches

Key Technology	Invasive				Noninvasive
	Lithotripsy	Histotripsy	Leaflet Scoring	Leaflet Splitting	NIUT
Mechanism	Unfocused shockwave emitted from a lithotripsy balloon. The pressure peak amplitudes on the edge of balloon to be 5∼20 Mpa	Ultrasonic shockwaves generated with piezoelectric generators. 2 frequencies: one about 30× greater than the other and avoid thermal injury	An expander that pushes the native aortic leaflets toward the frame for the creation of scoring lines. Designed to segment restrictive deposits and thereby increase leaflet mobility	Split/removes leaflets using specific devices eased by mechanical or electronic force. Mainly designed for coronary reaccess and prevention of coronary obstruction	Precisely focused pulse cavitational ultrasound delivered toward a predefined target within the aortic valve tissue. Pressure peak amplitudes at the focal spot to be up to 70 MPa
Status	Clinical study 10+ patients enrolled	Preclinical investigation	Clinical study 20+ patients enrolled	Clinical study 100+ patients enrolled	Clinical study 40+ patients enrolled
Follow-up	6 mo	—	1 y	1 y	6 mo
Retreatment	Yes	Yes	Yes	No	Yes
Current products and techniques	ShockWave (Shockwave Medical) TaurusWave (Peijia Medical)	Gemini (AorticLab)	Leaflex (Pi-Cardia)	ShortCut (Pi-Cardia) CATHEDRAL/BASILICA/UNICORN	Valvosoft (Cardiawave)

CATHEDRAL = CATHeter Electrosurgical Debulking and RemovAL; NIUT = noninvasive ultrasound therapy.