Transcatheter aortic valve implantation: patient selection

Stortecky, Stefan; O'Sullivan, Crochan John; Büllesfeld, Lutz; Wenaweser, Peter Martin; Windecker, Stephan (2013). Transcatheter aortic valve implantation: patient selection. Minerva cardioangiologica, 61(5), pp. 487-97.

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Transcatheter aortic valve implantation (TAVI) is a disruptive technology as it satisfies a previously unmet need which is associated with a profound therapeutic benefit. In randomized clinical trials, TAVI has been shown to improve survival compared with medical treatment among patients considered not suitable candidates for surgical aortic valve replacement (SAVR), and to provide similar outcomes as SAVR in selected high-risk patients. Currently, TAVI is limited to selected elderly patients with symptomatic severe aortic stenosis. As this patient population frequently suffers from comorbid conditions, which may influence outcomes, the selection of patients to undergo TAVI underlies a complex decision process. Several clinical risk score algorithms are routinely used, although they fall short to fully appreciate the true risk among patients currently referred for TAVI. Beyond traditional risk scores, the clinical assessment by an interdisciplinary Heart Team as well as detailed imaging of the aortic valve, aortic root, descending and abdominal aorta as well as peripheral vasculature are important prerequisites to plan a successful procedure. This review will familiarize the reader with the concepts of the interdisciplinary Heart team, risk scores as well as the most important imaging algorithms suited to select appropriate TAVI patients.

Item Type:

Journal Article (Review Article)

Division/Institute:

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

UniBE Contributor:

Stortecky, Stefan; O'Sullivan, Crochan John; Büllesfeld, Lutz; Wenaweser, Peter Martin and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1827-1618

Language:

English

Submitter:

Stefan Stortecky

Date Deposited:

24 Feb 2014 10:30

Last Modified:

20 May 2014 15:27

PubMed ID:

24096244

URI:

https://boris.unibe.ch/id/eprint/41946

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