[TAVI simplification: A focus]

Ann Cardiol Angeiol (Paris). 2019 Dec;68(6):418-422. doi: 10.1016/j.ancard.2019.09.017. Epub 2019 Oct 24.
[Article in French]

Abstract

After a first procedure carried out in 2002 by Pr Cribier's, Transcatheter Aortic Valve Replacement or TAVR revolutionized the management of aortic stenosis with a constant increase in the number of procedures performed worldwide. Experience of operators and teams and evolution of the technique has been accompanied by a drastic reduction in complications in patients at lower surgical risk. In parallel, the procedure was considerably simplified, carried out more and more under local anesthesia, with percutaneous femoral approach, secondary radial approach, prosthesis implantation without predilatation, rapid pacing on left ventricle wire and early discharge. Thus, the "simplified" TAVR adopted in most centers nowadays is a real revolution of the technique. However, simplified TAVR must be accompanied upstream by a rigorous selection of patients who can benefit from a minimalist procedure in order to guarantee its safety.

Keywords: Early discharge; Minimalist; Minimaliste; Parcours de soins; Pathway; Simplification; Sortie précoce; TAVI.

Publication types

  • Review

MeSH terms

  • Anesthesia, Conduction / methods
  • Anesthesia, Local
  • Aortic Valve Stenosis / surgery*
  • Cardiac Catheterization / instrumentation
  • Cardiac Catheterization / methods
  • Conscious Sedation
  • Femoral Artery
  • Heart Valve Prosthesis Implantation / methods
  • Humans
  • Hypotension, Controlled / methods
  • Patient Care Team
  • Patient Selection*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / prevention & control
  • Radial Artery
  • Transcatheter Aortic Valve Replacement / adverse effects
  • Transcatheter Aortic Valve Replacement / methods*
  • Transcatheter Aortic Valve Replacement / trends
  • Work Simplification