20 December 2012 (online)
The treatment of choice of symptomatic aortic stenosis is aortic valve replacement, as it leads to congestive heart failure and death. But still about 30 – 40 % of patients in Western Europe are not being treated due to age or comorbidities. Transcatheter aortic valve implantation is a new method to treat especially this high-risk group of patient. It has proven to be as effective and safe as conventional surgical aortic valve replacement. All patients have to be discussed in a special „Heart Team” to validate the eligibility for transcatheter aortic valve implantation. With the increasing improvement of the different valve-systems the complication rates could be reduced constantly. Current studies investigate the eligibility of the new transcatheter procedures in low to intermediate risk patients. Further application fields like trancatheter valve implantion in mitral- or tricuspidal position are in development.
- 1 Iung B, Cachier A, Baron G et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery?. Eur Heart J 2005; 26: 2714-2720
- 2 Cribier A, Eltchaninoff H, Bash A et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation 2002; 106: 3006-3008
- 3 Smith CR, Leon MB, Mack MJ et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 2011; 364: 2187-2198
- 4 Leon MB, Smith CR, Mack M et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010; 363: 1597-1607
- 5 Gilard M, Eltchaninoff H, Iung B et al. Registry of transcatheter aortic-valve implantation in high-risk patients. N Engl J Med 2012; 366: 1705-1715
- 6 Eggebrecht H, Schafer U, Treede H et al. Valve-in-valve transcatheter aortic valve implantation for degenerated bioprosthetic heart valves. JACC Cardiovasc Interv 2011; 4: 1218-1227
- 7 Schroeter T, Linke A, Haensig M et al. Predictors of permanent pacemaker implantation after Medtronic CoreValve bioprosthesis implantation. Europace 2012; DOI: 10.1093/europace/eus191.
- 8 Gurvitch R, Wood DA, Tay EL et al. Transcatheter aortic valve implantation: durability of clinical and hemodynamic outcomes beyond 3 years in a large patient cohort. Circulation 2010; 122: 1319-1327
- 9 Gotzmann M, Korten M, Bojara W et al. Long-Term Outcome of Patients With Moderate and Severe Prosthetic Aortic Valve Regurgitation After Transcatheter Aortic Valve Implantation. Am J Cardiol 2012; 110 (10) 1500-1506
- 10 Kappetein AP, Head SJ, Genereux P et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. EuroIntervention 2012; published ahead of print October 1