Transcatheter aortic valve implantation is a promising technique for elderly, high-risk patients with severe aortic stenosis, though no randomized clinical trials have been reported so far.
Does transcatheter aortic valve implantation provide a safe and effective alternative to conventional surgery in elderly and higher-risk patients with severe aortic stenosis?
TAVI is emerging as a promising clinical reality for high-risk patients with severe aortic stenosis, though randomized trial data is still pending.
PURPOSE OF REVIEW: Transcatheter aortic valve implantation is a new, emerging technique that has been performed in elderly and higher-risk patients suffering severe, symptomatic aortic stenosis. RECENT FINDINGS: Initial clinical results are promising. Important technological progress, i.e. the development of two stent-based aortic valve xenografts (the CoreValve prosthesis with a nitinol frame and the Edwards Sapien prosthesis with a steel stent), has allowed these achievements. Both prostheses can be crimped to small diameters, allowing for implantation by either a transfemoral or a transapical approach. Recently, CE mark approval has been obtained for both prostheses for transfemoral implantation. This will likely lead to an increased number of implantations. Current clinical studies are of prospective design with observational character. No prospectively randomized clinical trials have been reported so far; however, one randomized trial is under way. SUMMARY: Transcatheter aortic valve implantation has become a clinical reality and will be performed more frequently in the future. Patient selection is critical and current indications include only higher-risk patients suffering severe aortic stenosis. When selecting the optimal therapy for individual patients, the advantages and disadvantages of this novel approach must be carefully weighed against the excellent results achieved with conventional surgery.
Walther et al. (Sat,) conducted a review in Severe, symptomatic aortic stenosis. Transcatheter aortic valve implantation vs. Conventional surgery was evaluated. Transcatheter aortic valve implantation is a promising technique for elderly, high-risk patients with severe aortic stenosis, though no randomized clinical trials have been reported so far.
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