Key result
Transcatheter aortic valve implantation (TAVI) improves symptoms and yields similar 1-year morbidity and mortality compared to open surgical aortic valve replacement in high-risk elderly patients.
TAVI is a viable option for high-risk or inoperable patients with aortic stenosis, requiring specialized perioperative anesthetic and hemodynamic management.
Supports TAVI consideration in high-risk elderly aortic stenosis; leaves open durability and lower-risk applicability.
Aortic stenosis is a prevalent valvular disease among aging patients, and surgical correction is the most definitive treatment. Yet many elderly patients are deemed to be "inoperable" or at excessive risk to undergo open surgical aortic valve replacement (AVR). Transcatheter aortic valve implantation (TAVI), either through a transfemoral or transapical approach, has become a potential option for these high-risk patients. Although TAVI technology will continue to be developed and perfected, most studies at this time reveal that symptoms are improved and that 1-year morbidity and mortality are similar to those for open surgical AVR. Anesthetic management for patients undergoing TAVI involves maintaining hemodynamic stability during periods of rapidly changing conditions and providing echocardiographic guidance and assessment. Postoperative care includes a variety of challenges such as managing pain control, monitoring for potential complications, and providing hemodynamic management.
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Huffmyer et al. (2012) conducted a review in Aortic stenosis. Transcatheter aortic valve implantation (TAVI) vs. Open surgical aortic valve replacement (AVR) was evaluated. Transcatheter aortic valve implantation (TAVI) improves symptoms and yields similar 1-year morbidity and mortality compared to open surgical aortic valve replacement in high-risk elderly patients.
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