Transcatheter aortic valve implantation (TAVI) – current situation and news in 2013

Česká verzia

Authors: V. Kočka; P. Toušek
Authors place of work: Kardiocentrum, FN Královské Vinohrady
Published in the journal: Kardiol Rev Int Med 2013, 15(3): 149-152
Category: Chlopenní vady

Summary

Transcatheter aortic valve implantation (TAVI) as a new but now widely accepted method has become a routine part of modern interventional cardiology. Our review article will at first introduce the design of the two currently approved and dominant valve prostheses. We present a comparison of patient characteristics and results between the early phase (Partner study) and current situation (recently published in the Sentinel registry). In 2013, there are several new approaches and the importance of CT based evaluation of aortic annulus size and the safest vascular access are highlighted. There are two less common indications of TAVI technology – so- called valve- in‑valve for therapy of degenerated aortic bioprosthesis and the second indication is therapy of pure aortic regurgitation. We discuss the results as well as the risks. As far as long‑term results are concerned, preliminary data from a five‑year patient follow‑up and the results with this catheter based technology are very optimistic. We present the economic analysis of the Partner study performed in the USA and we have performed a preliminary comparison of in‑hospital costs between TAVI and surgical aortic valve replacement (AVR) within Czech healthcare – it seems that the cost difference (once the price of post‑operative care is included) is not dramatic. The patient who, despite the recommendation of Heart Team prefers TAVI to AVR, presents an ethical dilemma. Can the patient make this choice? Finally, we briefly present our results of the TAVI programme in University Hospital Královské Vinohrady.

Keywords:
aortic stenosis – transcatheter aortic valve implantation

Zdroje

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