Key result
Transcatheter aortic valve therapy (TAVI) is increasingly used for patients outside conventional high-risk criteria, including those with nonstandard anatomy or requiring novel access sites.
TAVI indications are expanding beyond traditional high-risk surgical patients to include those with nonstandard anatomy, prior bioprosthetic valves, and alternative vascular access needs.
May support TAVI consideration in select nonstandard cases; leaves open prospective trials to define safety and outcomes.
Transcatheter aortic valve therapy (TAVI) is an important therapeutic strategy for patients with severe aortic stenosis who are considered ‘high-risk’ for conventional surgery. Traditionally, this has been defined as a logistic EUROSCORE of >20 (subsequently reduced to >15) or a Society of Thoracic Surgeons score of >10. Despite the increasing numbers of patients undergoing treatment (>50,000 to date, worldwide), it remains a relatively new technology. It has become increasingly clear that there are a number of patients who do not fulfill ‘conventional’ criteria for TAVI, who have undergone successful implantation. These include patients who do not meet these standard risk scores, patients with ‘nonstandard’ aortic valve anatomy and those who have undergone previous bioprosthetic surgical valve replacement. Furthermore, a number of patients are unsuitable for standard forms of vascular access and this has prompted the development of several novel access sites. This review summarizes the current use of the...
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Byrne et al. (2012) conducted a review in severe aortic stenosis. Transcatheter aortic valve therapy (TAVI) was evaluated. Transcatheter aortic valve therapy (TAVI) is increasingly used for patients outside conventional high-risk criteria, including those with nonstandard anatomy or requiring novel access sites.
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