Authors

• Mario Sičaja — University Hospital Dubrava, Zagreb, Croatia — ORCID: 0000-0003-0773-4720

Abstract

Aortic valve stenosis is the rather common acquired valve disease in the developed world. As a conundrum in treatment of patients with severe aortic stenosis, classified as intermediate- and high-risk, transfemoral or transapical aortic valve implantation (TAVI) has emerged. The TAVI approach has been shown to be superior to standard medical treatment in patients classified as high-risk (Euroscore II and STS), and non-inferior to surgical aortic valve replacement in intermediate risk group (1). A successful program depends on multiple variables such as appropriate patient selection that is based on so-called ‘Heart Team’, careful planning and good quality control of maintaining high standards during and after the procedure (2). Once a TAVI program is in place, it is necessary to have performance monitoring measures in order to recognize weaknesses of the program as well as to improve procedure outcomes. This short lecture focuses on fundamentals of running a TAVI program with some reflections regarding the current situation in Croatia.

Keywords

aortic stenosis, aortic valve replacement, transcatheter aortic valve implantation

DOI

Literature

1. Arora S, Misenheimer JA, Jones W, Bahekar A, Caughey M, Ramm CJ, et al. Transcatheter versus surgical aortic valve replacement in intermediate risk patients: a meta-analysis. Cardiovasc Diagn Ther. 2016 Jun;6(3):241–9. https://doi.org/10.21037/cdt.2016.03.04
2. Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011 Jun 9;364(23):2187–98. https://doi.org/10.1056/NEJMoa1103510