Transcatheter aortic valve implantation: Update in 2018

Eur J Intern Med. 2018 Sep:55:12-19. doi: 10.1016/j.ejim.2018.07.002. Epub 2018 Jul 4.

Abstract

During the last 15 years, transcatheter aortic valve implantation (TAVI) has gained wide acceptance with good reproducible clinical and safety outcomes. Today, TAVI has not only overtaken conventional surgery as the standard of care for the treatment of patients with symptomatic aortic stenosis at high surgical risk, but can also be considered in selected intermediate-risk patients. This follows technological improvements, better patient assessment and increased operator experience leading to a significant reduction in most procedure-related complications and long-term mortality. In this review, we provide internists, on the one hand with current data in the TAVI field including clinical outcomes from the most recent, major trials and on the other hand, highlight the remaining pitfalls of this treatment and the gaps in evidence that need to be addressed in order to further improve clinical practice and expand its indication.

Keywords: Intermediate risk; Pacemaker implantation; Paravalvular leak; Transcatheter aortic valve implantation; VARC.

Publication types

  • Review

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis / surgery*
  • Heart Valve Prosthesis / adverse effects*
  • Humans
  • Patient Selection
  • Postoperative Complications / etiology
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk Factors
  • Transcatheter Aortic Valve Replacement / adverse effects*
  • Transcatheter Aortic Valve Replacement / trends*