Erkrankungen der Aorta/Herzklappen – Stichwort TAVI

Die Behandlung der symptomatischen Aortenklappenstenose hat im letzten Jahrzehnt eine rasante Entwicklung erfahren. Die anfänglich nur bei inoperablen Patienten oder hohem OP-Risiko gewählte Transcatheter Aortic Valve Implantation (TAVI) wird zunehmend auch bei intermediärem und niedrigem OP-Risiko indiziert. Neben der korrekten, individuell auf den Patienten abgestimmten Therapieempfehlung des Heart-Teams ist insbesondere die peri- und postinterventionelle Überwachung und Betreuung für die Prognose wichtig.

Schlüsselwörter

TAVI - Aortenklappenstenose - Komplikationsmanagement

• Literatur

• 1 Iung B, Baron G, Butchart EG. et al. A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. Eur Heart J 2003; 24: 1231-1243 doi:10.1016/S0195-668x(03)00201-X
• 2 Vahanian A, Alfieri O, Andreotti F. et al. Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg 2012; 42: S1-S44 doi:10.1093/ejcts/ezs455
• 3 Pawade TA, Newby DE, Dweck MR. Calcification in aortic stenosis: the skeleton key. J Am Coll Cardiol 2015; 66: 561-577 doi:10.1016/j.jacc.2015.05.066
• 4 Bonow RO, Carabello BA, Chatterjee K. et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008; 52: e1-e142 doi:10.1016/j.jacc.2008.05.007
• 5 Schwarz F, Baumann P, Manthey J. et al. The effect of aortic valve replacement on survival. Circulation 1982; 66: 1105-1110 doi:10.1161/01.cir.66.5.1105
• 6 Cribier A, Savin T, Saoudi N. et al. Percutaneous transluminal valvuloplasty of acquired aortic stenosis in elderly patients: an alternative to valve replacement?. Lancet 1986; 1: 63-67 doi:10.1016/s0140-6736(86)90716-6
• 7 Baumgartner H, Falk V, Bax JJ. et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 2017; 38: 2739-2791 doi:10.1093/eurheartj/ehx391
• 8 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 doi:10.1161/01.cir0000047200.36165.b8
• 9 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 doi:10.1056/NEJMoa1008232
• 10 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 doi:10.1056/NEJMoa1103510
• 11 Adams DH, Popma JJ, Reardon MJ. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med 2014; 371: 967-968 doi:10.1056/NEJMc1408396
• 12 Reardon MJ, Van Mieghem NM, Popma JJ. et al. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med 2017; 376: 1321-1331 doi:10.1056/NEJMoa1700456
• 13 Leon MB, Smith CR, Mack MJ. et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med 2016; 374: 1609-1620 doi:10.1056/NEJMoa1514616
• 14 Eggebrecht H, Mehta RH. Transcatheter aortic valve implantation (TAVI) in Germany: more than 100,000 procedures and now the standard of care for the elderly. EuroIntervention 2019; 14: e1549-e1552 doi:10.4244/EIJ-D-18-01010
• 15 Siontis GCM, Overtchouk P, Cahill TJ. et al. Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: an updated meta-analysis. Eur Heart J 2019; 40: 3143-3153 doi:10.1093/eurheartj/ehz275
• 16 Popma JJ, Deeb GM, Yakubov SJ. et al. transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med 2019; 380: 1706-1715 doi:10.1056/NEJMoa1816885
• 17 Mack MJ, Leon MB, Thourani VH. et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med 2019; 380: 1695-1705 doi:10.1056/NEJMoa1814052
• 18 Deutsche Gesellschaft für Kardiologie – DGK. Pressetext DGK 04/2019. Im Internet (Stand: 12.07.2020): https://dgk.org/daten/PA-TAVI-final.pdf
• 19 Food and Drug Administration – FDA. FDA-Pressemitteilung 08/2019. Im Internet (Stand: 12.07.2020): https://www.fda.gov/news-events/press-announcements/fda-expands-indication-several-transcatheter-heart-valves-patients-low-risk-death-or-major
• 20 Rodriguez-Gabella T, Voisine P, Dagenais F. et al. Long-term outcomes following surgical aortic bioprosthesis implantation. J Am Coll Cardiol 2018; 71: 1401-1412 doi:10.1016/j.jacc.2018.01.059
• 21 Christ T, Claus B, Borck R. et al. The St. Jude Toronto stentless bioprosthesis: up to 20 years follow-up in younger patients. Heart Surg Forum 2015; 18: E129-E133 doi:10.1532/hsf.1252
• 22 Makkar RR, Thourani VH, Mack MJ. et al. Five-year outcomes of transcatheter or surgical aortic-valve replacement. N Engl J Med 2020; 382: 799-809 doi:10.1056/NEJMoa1910555
• 23 Testa L, Latib A, Brambilla N. et al. Long-term clinical outcome and performance of transcatheter aortic valve replacement with a self-expandable bioprosthesis. Eur Heart J 2020; 41: 1876-1886 doi:10.1093/eurheartj/ehz925
• 24 Dangas GD, Tijssen JGP, Wohrle J. et al. A controlled trial of rivaroxaban after transcatheter aortic-valve replacement. N Engl J Med 2020; 382: 120-129 doi:10.1056/NEJMoa1911425
• 25 Husser O, Fujita B, Hengstenberg C. et al. Conscious sedation versus general anesthesia in transcatheter aortic valve replacement: The German Aortic Valve Registry. JACC Cardiovasc Interv 2018; 11: 567-578 doi:10.1016/j.jcin.2017.12.019
• 26 Eggebrecht H, Vaquerizo B, Moris C. et al. Incidence and outcomes of emergent cardiac surgery during transfemoral transcatheter aortic valve implantation (TAVI): insights from the European Registry on Emergent Cardiac Surgery during TAVI (EuRECS-TAVI). Eur Heart J 2018; 39: 676-684 doi:10.1093/eurheartj/ehx713
• 27 Genereux P, Head SJ, Van Mieghem NM. et al. Clinical outcomes after transcatheter aortic valve replacement using valve academic research consortium definitions: a weighted meta-analysis of 3,519 patients from 16 studies. J Am Coll Cardiol 2012; 59: 2317-2326 doi:10.1016/j.jacc.2012.02.022
• 28 Hayashida K, Lefevre T, Chevalier B. et al. Transfemoral aortic valve implantation new criteria to predict vascular complications. JACC Cardiovasc Interv 2011; 4: 851-858 doi:10.1016/j.jcin.2011.03.019
• 29 Kodali SK, Williams MR, Smith CR. et al. Two-year outcomes after transcatheter or surgical aortic-valve replacement. N Engl J Med 2012; 366: 1686-1695 doi:10.1056/NEJMoa1200384
• 30 van Rosendael PJ, Delgado V, Bax JJ. Pacemaker implantation rate after transcatheter aortic valve implantation with early and new-generation devices: a systematic review. Eur Heart J 2018; 39: 2003-2013 doi:10.1093/eurheartj/ehx785
• 31 Kusumoto FM, Schoenfeld MH, Barrett C. et al. 2018 ACC/AHA/HRS Guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. J Am Coll Cardiol 2019; 74: 932-987 doi:10.1016/j.jacc.2018.10.043
• 32 Rodes-Cabau J, Ellenbogen KA, Krahn AD. et al. Management of conduction disturbances associated with transcatheter aortic valve replacement: JACC Scientific Expert Panel. J Am Coll Cardiol 2019; 74: 1086-1106 doi:10.1016/j.jacc.2019.07.014
• 33 Van Mieghem NM, Schipper ME, Ladich E. et al. Histopathology of embolic debris captured during transcatheter aortic valve replacement. Circulation 2013; 127: 2194-2201 doi:10.1161/CIRCULATIONAHA.112.001091
• 34 Zaleska-Kociecka M, Dabrowski M, Stepinska J. Acute kidney injury after transcatheter aortic valve replacement in the elderly: outcomes and risk management. Clin Interv Aging 2019; 14: 195-201 doi:10.2147/CIA.S149916
• 35 Nijenhuis VJ, Brouwer J, Delewi R. et al. Anticoagulation with or without clopidogrel after transcatheter aortic-valve implantation. N Engl J Med 2020; 382: 1696-1707 doi:10.1056/NEJMoa1915152
• 36 Kuck K-H, Eggebrecht H, Elsässer A. et al. Qualitätskriterien zur Durchführung der kathetergestützten Aortenklappenimplantation (TAVI). Kardiologe 2016; 10: 282-300