PMID- 26578195
DCOM- 20170103
LR  - 20170104
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 37
IP  - 10
DP  - 2016 Mar 7
TI  - The future of transcatheter aortic valve implantation.
PG  - 803-10
LID - 10.1093/eurheartj/ehv574 [doi]
AB  - Since the introduction of transcatheter aortic valve implantation (TAVI) into
      clinical practice, the treatment of aortic stenosis has changed dramatically. In 
      the past, medical therapy with or without balloon aortic valvuloplasty was the
      only option for inoperable patients. More recently, TAVI has become the treatment
      of choice for these patients and the preferred alternative for high-risk operable
      patients. Surgical aortic valve replacement (SAVR) currently remains the gold
      standard for patients at low or intermediate operative risk. As randomized trials
      have demonstrated comparable results between TAVI and SAVR in the high-risk
      population, there is now a clear trend towards performing TAVI even in
      intermediate-risk patients while awaiting the results of randomized trials in
      that population. Nevertheless, there are still questions regarding TAVI involving
      paravalvular leak (PVL), stroke, pacemaker requirements, and durability that
      remain to be more definitively answered before TAVI can routinely be performed in
      a broader, lower risk population. Improvements in patient selection, imaging, and
      second and third generation devices have decreased the incidence of PVLs and
      vascular complications that followed the earliest TAVI procedures, but the rates 
      of perioperative stroke and permanent pacemaker implantation must still be
      addressed. Furthermore, the long-term durability of TAVI devices and a role for
      post-procedure antithrombotic management remain unanswered. Until these questions
      are more clearly answered, it is the Heart Team's task to determine the optimal
      treatment for each patient based on risk scores, frailty metrics, comorbidities, 
      patient preference, and potential for improvement in quality of life.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved.
      (c) The Author 2015. For permissions please email:
FAU - Hamm, Christian W
AU  - Hamm CW
AD  - Department of Medical Clinic I, University of Giessen, Klinikstr. 33, Giessen
      35392, Germany Department Cardiac Surgery, Kerckhoff Heart Center, Benekestrasse 
      2-8, Bad Nauheim 61231, Germany
FAU - Arsalan, Mani
AU  - Arsalan M
AD  - Department Cardiac Surgery, Kerckhoff Heart Center, Benekestrasse 2-8, Bad
      Nauheim 61231, Germany The Heart Hospital Baylor Plano, 1100 Allied Drive, Plano,
      TX 75093, USA.
FAU - Mack, Michael J
AU  - Mack MJ
AD  - Cardiovascular Surgery, Baylor Health Care System, Dallas, TX, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20151117
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Fibrinolytic Agents)
RN  - Bicuspid Aortic Valve
SB  - IM
MH  - Aortic Valve/abnormalities/surgery
MH  - Aortic Valve Insufficiency
MH  - Aortic Valve Stenosis/*surgery
MH  - Fibrinolytic Agents/therapeutic use
MH  - Forecasting
MH  - Global Health/statistics & numerical data
MH  - Heart Valve Diseases/complications/surgery
MH  - Heart Valve Prosthesis/adverse effects/standards
MH  - Humans
MH  - Pacemaker, Artificial/statistics & numerical data
MH  - Patient Selection
MH  - Postoperative Complications/etiology
MH  - Practice Guidelines as Topic
MH  - Prosthesis Failure
MH  - Reimbursement Mechanisms
MH  - Risk Factors
MH  - Stroke/prevention & control
MH  - Transcatheter Aortic Valve Replacement/adverse effects/statistics & numerical
MH  - Vascular Calcification/surgery
OT  - Aortic regurgitation
OT  - Aortic stenosis
OT  - Aortic valve surgery
OT  - Transcatheter aortic valve implantation
OT  - Transcatheter aortic valve replacement
EDAT- 2015/11/19 06:00
MHDA- 2017/01/04 06:00
CRDT- 2015/11/19 06:00
PHST- 2015/07/09 00:00 [received]
PHST- 2015/10/05 00:00 [accepted]
PHST- 2015/11/19 06:00 [entrez]
PHST- 2015/11/19 06:00 [pubmed]
PHST- 2017/01/04 06:00 [medline]
AID - ehv574 [pii]
AID - 10.1093/eurheartj/ehv574 [doi]
PST - ppublish
SO  - Eur Heart J. 2016 Mar 7;37(10):803-10. doi: 10.1093/eurheartj/ehv574. Epub 2015
      Nov 17.