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Wien Med Wochenschr · Aug 2012
Review Comparative Study[Transcatheter aortic valve replacement: when should it be used in aortic stenosis?].
- Lukas Jaroslaw Motloch, Sara Reda, Dennis Rottlaender, Matthias Heigert, and Uta C Hoppe.
- Universitätsklinik für Innere Medizin II, Paracelsus Medizinische Privatuniversität Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Österreich. l.motloch@salk.at
- Wien Med Wochenschr. 2012 Aug 1;162(15-16):340-8.
Abstract30% of patients with significant aortic stenosis are not considered for operative aortic valve replacement because of the high perioperative risk. An alternative catheter based option for these patients is the transcatheter aortic valve replacement (TAVI). In general, there are two approaches for TAVI: transfemoral and transapical. Transfemoral aortic valve replacement is performed by transcatheter replacement of an aortic valve via the femoral arteries. Transapical valve replacement is achieved by transcatheter implantation via the fifth intercostal space. The most common complications are vessel injuries, bleeding complications, new onset of AV-block, development of paravalvular insufficiency, acute kidney injury, stroke and TIA. The first long-term observations suggest positive results. First clinical trials in a high-risk population show a promising outcome. Therefore TAVI offers a reasonable therapy option for patients with high perioperative risk. Further long-term clinical trials are still pending.
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