Key result
Patient selection for transcatheter aortic valve implantation requires systematic evaluation of clinical risk profiles and anatomical suitability using multimodality imaging.
Meticulous patient selection using multimodality imaging and risk profiling is crucial for the success and safety of TAVI in high-risk patients with severe aortic stenosis.
Supports meticulous TAVI selection in practice; leaves open standardization of multimodality imaging protocols for prospective validation.
Patient selection plays a crucial role in the success of transcatheter aortic valve implantation (TAVI). It requires meticulous attention to the smallest of details and needs to be performed in a systematic manner for every patient. In essence, the patient must be assessed from access to implantation site. Becoming over "complacent" and "routine" may lead to failure and impact patient safety. TAVI is indicated for high or prohibitive surgical risk patients with severe aortic stenosis. Some patients, however, are too high risk even for TAVI. In addition to patient risk evaluation, anatomical selection criteria need to be considered. Multimodality imaging, using a combination of angiography, echocardiography and multislice computed tomography, is necessary to determine the anatomical suitability for the procedure.
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Piazza et al. (2012) conducted a review in Severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) was evaluated. Patient selection for transcatheter aortic valve implantation requires systematic evaluation of clinical risk profiles and anatomical suitability using multimodality imaging.
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