Focus on Transcatheter Aortic Valve Implantation in Low-Risk Patients
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In just more than a decade since the first patients were enrolled in the PARTNER I trial, transcatheter aortic valve implantation (TAVI) has become the treatment of choice for elderly high-risk patients with severe aortic stenosis. Robust randomized trial data from intermediate-risk patient cohorts also support the net superiority of TAVI when undertaken via femoral approach. As the focus now moves to evidence-based treatment of low-risk patients, ongoing trials must address a number of key differentiating features that uniquely define this group of often-younger patients with fewer comorbidities and longer life expectancy. This chapter focuses on the clinical and procedural challenges associated with the percutaneous treatment of the large low-risk cohort of patients with severe aortic stenosis.
KeywordsTranscatheter Aortic stenosis Low-risk Clinical trials Risk score Permanent pacemaker Paravalvular leak Stroke Bicuspid aortic valve Valve durability Leaflet thrombosis
- 10.Sondergaard L, Steinbruchel DA, Ihlemann N, et al. Two-year outcomes in patients with severe aortic valve stenosis randomized to transcatheter versus surgical aortic valve replacement: the all-comers nordic aortic valve intervention randomized clinical trial. Circ Cardiovasc Interv. 2016;9(6)Google Scholar
- 11.Popma JJ, Reardon MJ, Khabbaz K, et al. Early clinical outcomes after transcatheter aortic valve replacement using a novel self-expanding bioprosthesis in patients with severe aortic stenosis who are suboptimal for surgery: results of the Evolut R U.S. study. JACC Cardiovasc Interv. 2017;10(3):268–75.CrossRefGoogle Scholar
- 28.Capodanno D, Petronio AS, Prendergast B, et al. Standardized definitions of structural deterioration and valve failure in assessing long-term durability of transcatheter and surgical aortic bioprosthetic valves: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) endorsed by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2017;38(45):3382–90.CrossRefGoogle Scholar