• Alec Vahanian, Ottavio R Alfieri, Nawwar Al-Attar, Manuel J Antunes, Jeroen Bax, Bertrand Cormier, Alain Cribier, Peter De Jaegere, Gerard Fournial, Arie Pieter Kappetein, Jan Kovac, Susanne Ludgate, Francesco Maisano, Neil Moat, Friedrich-Wilhelm Mohr, Patrick Nataf, Luc Pierard, José Luis Pomar, Joachim Schofer, Pilar Tornos, Murat Tuzcu, Ben van Hout, Ludwig K von Segesser, and Thomas Walther.
• Hôpital Bichat, Paris, France. alec.vahanian@bch.aphp.fr <alec.vahanian@bch.aphp.fr>
• Eur J Cardiothorac Surg. 2008 Jul 1;34(1):1-8.

AimsTo critically review the available transcatheter aortic valve implantation techniques and their results, as well as propose recommendations for their use and development.Methods And ResultsA committee of experts including European Association of Cardio-Thoracic Surgery and European Society of Cardiology representatives met to reach a consensus based on the analysis of the available data obtained with transcatheter aortic valve implantation and their own experience. The evidence suggests that this technique is feasible and provides haemodynamic and clinical improvement for up to 2 years in patients with severe symptomatic aortic stenosis at high risk or with contraindications for surgery. Questions remain mainly concerning safety and long-term durability, which have to be assessed. Surgeons and cardiologists working as a team should select candidates, perform the procedure, and assess the results. Today, the use of this technique should be restricted to high-risk patients or those with contraindications for surgery. However, this may be extended to lower risk patients if the initial promise holds to be true after careful evaluation.ConclusionTranscatheter aortic valve implantation is a promising technique, which may offer an alternative to conventional surgery for high-risk patients with aortic stenosis. Today, careful evaluation is needed to avoid the risk of uncontrolled diffusion.

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