The SURTAVI model: proposal for a pragmatic risk stratification for patients with severe aortic stenosis

van Mieghem, Nicolas M; Head, Stuart J; van der Boon, Robert M A; Piazza, Nicolo; de Jaegere, Peter P; Carrel, Thierry; Kappetein, A Pieter; Lange, Ruediger; Walther, Thomas; Windecker, Stephan; van Es, Gerrit-Anne; Serruys, Patrick W (2012). The SURTAVI model: proposal for a pragmatic risk stratification for patients with severe aortic stenosis. EuroIntervention, 8(2), pp. 258-66. Toulouse: Europa Digital & Publishing 10.4244/EIJV8I2A40

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Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical aortic valve replacement (SAVR) for patients with symptomatic severe aortic stenosis (AS) and a high operative risk. Risk stratification plays a decisive role in the optimal selection of therapeutic strategies for AS patients. The accuracy of contemporary surgical risk algorithms for AS patients has spurred considerable debate especially in the higher risk patient population. Future trials will explore TAVI in patients at intermediate operative risk. During the design of the SURgical replacement and Transcatheter Aortic Valve Implantation (SURTAVI) trial, a novel concept of risk stratification was proposed based upon age in combination with a fixed number of predefined risk factors, which are relatively prevalent, easy to capture and with a reasonable impact on operative mortality. Retrospective application of this algorithm to a contemporary academic practice dealing with clinically significant AS patients allocates about one-fourth of these patients as being at intermediate operative risk. Further testing is required for validation of this new paradigm in risk stratification. Finally, the Heart Team, consisting of at least an interventional cardiologist and cardiothoracic surgeon, should have the decisive role in determining whether a patient could be treated with TAVI or SAVR.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Carrel, Thierry and Windecker, Stephan

ISSN:

1774-024X

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:31

Last Modified:

17 Mar 2015 21:17

Publisher DOI:

10.4244/EIJV8I2A40

PubMed ID:

22912963

Web of Science ID:

000307432500014

URI:

https://boris.unibe.ch/id/eprint/11840 (FactScience: 218090)

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