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Worldwide TAVI registries: what have we learned?

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Abstract

With a rapidly aging society, the number of patients with cardiovascular disease—in particular aortic stenosis—is progressively increasing. Although conventional aortic valve replacement remains the only treatment known to improve prognosis and symptoms in symptomatic patients with aortic stenosis, about one-third are still withhold from the life-saving therapy. Based on the compelling evidence of the randomized Placement of Aortic transcatheter valves (PARTNER) A and B cohort, TAVI is now considered standard of care for extreme risk and inoperable patients and is an alternative to surgery for high-risk patients with symptomatic aortic stenosis. However, these patients were super-selected, which does not reflect a clinical real-world situation. TAVI registries represent a real-world scenario, and therefore provide the evidence for the treatment of high-risk patients (regarding comorbidities and anatomical factors) in daily clinical life. The review will focus on the recently published Edwards SAPIEN, Medtronic CoreValve and mixed (national) registries with the focus on short- and midterm outcome. These registries suggest that the growing experience of the operators with regard to patient selection, prevention, recognition and treatment of procedural complications together with the developments in valve design will improve the short-term results of TAVI. However, randomized trials in intermediate risk patients and data on long-term valve durability are a prerequisite before indications can be expanded to younger and lower risk patient population.

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Acknowledgments

Dr. Linke is a consultant to Medtronic and St. Jude Medical. He received speaker honoraria from Edwards, Medtronic and St. Jude Medical and is a proctor for Medtronic, Edwards and St. Jude Medical. Prof. Schuler and Dr. Haussig report no conflict of interest.

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  1. Department of Internal Medicine/Cardiology, Heart Center, University of Leipzig, Strümpellstrasse 39, 04289, Leipzig, Germany

    Stephan Haussig, Gerhard Schuler & Axel Linke

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  1. Stephan Haussig
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Correspondence to Axel Linke.

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This article is part of a series of 3 articles on TAVI that will be published in subsequent issues.

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Haussig, S., Schuler, G. & Linke, A. Worldwide TAVI registries: what have we learned?. Clin Res Cardiol 103, 603–612 (2014). https://doi.org/10.1007/s00392-014-0698-y

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