Treatment of severe symptomatic aortic stenosis in the elderly: Surgical AVR (aortic valve replacement), TAVI (transcatheter aortic valve implantation) or medical therapy

2013 ◽  
Vol 4 ◽  
pp. S147
Author(s):  
V. Collas ◽  
Y.M. Chong ◽  
I. Rodrigus ◽  
A. De Hondt ◽  
M. Vandewoude ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Medical Therapy ◽  
Transcatheter Aortic Valve Implantation ◽  
The Elderly ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

scholarly journals Severe aortic stenosis in the young, with or without bicuspid valve: is transcatheter aortic valve implantation the first choice?

2020 ◽  
Vol 22 (Supplement_L) ◽  
pp. L1-L5
Author(s):  
Igor Belluschi ◽  
Nicola Buzzatti ◽  
Alessandro Castiglioni ◽  
Michele De Bonis ◽  
Matteo Montorfano ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Implantation ◽  
Surgical Risk ◽  
Transcatheter Aortic Valve ◽  
First Choice ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract During the last decade, transcatheter aortic valve implantation (TAVI) has represented a valid alternative to surgical aortic valve replacement in patients with aortic stenosis and elevated surgical risk. Recent randomized clinical trials reported excellent results also for patients at low surgical risk, but in clinical practice, the mean age of the patients treated remain over 75 years, and the presence of a bicuspid aortic valve still represents an important exclusion criteria. Today, aortic valve replacement with a mechanical prosthesis remains the treatment of choice for young adults with aortic stenosis, although the desire to avoid oral anticoagulants drives more patients younger than 65 years of age towards biological prostheses. Furthermore, despite the follow-up of patients after TAVI is still limited to a few years, the opportunity of a second percutaneous treatment (TAVI-in-TAVI), extends the scope of percutaneous strategy. In the next few years, TAVI has to face many challenges to become a valid alternative to surgery in the younger patients as well.

scholarly journals Treatment of high-risk patients with severe aortic stenosis by the use of transcatheter aortic valve implantation

2018 ◽  
Vol 9 (1) ◽  
pp. 84-89
Author(s):  
Alexey V. Sizov ◽  
Alexey S. Sergeev ◽  
Evgeny A. Shloydo ◽  
Valentin K. Suchov ◽  
Victoria V. Zvereva
Keyword(s):  
High Risk ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Implantation ◽  
Age Groups ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Aortic stenosis is the most common disease from the group of acquired heart diseases. The frequency and degree of damage of the aortic valve increases with age. The prevalence of this disease increases due to the general extension in life expectancy of the population. Aortic valve stenosis caused by calcification is the pathology with progressive course characterized by a poor prognosis at the stage of expanded symptoms. Five-year survival of patients with developed clinical picture of aortic stenosis without surgery, according to some estimates, is reduced to 15%, which is the worst figure, even in comparison with most potentially incurable cancer. In the treatment of aortic stenosis aortic valve replacement is the “gold standard” and gives positive results in all age groups of patients. Only one third of patients are sent for aortic valve replacement owing to high risk caused by the age, severity of the defect, reduced contractility of the left ventricle, pulmonary hypertension and other comorbidities. Aortic valve replacement in patients of the older age groups with concomitant diseases is associated with high level of hospital mortality. One of the attempts to reduce the frequency of complications and mortality in this group of patients is the implementation of a less traumatic surgery – transcatheter aortic valve implantation. At present our clinic has successfully performed more than 70 operations of transcatheter aortic valve implantation. Transcatheter aortic valve implantation is a good alternative to standard aortic valve replacement in patients with high risk of open-heart surgery.

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