[Transapical aortic valve implantation--indications, risks and limitations]

Area of Science:

• Cardiology
• Cardiac Surgery
• Interventional Cardiology

Context:

• Calcified aortic stenosis is the most prevalent heart valve disease in Western countries.
• Surgical aortic valve replacement is the standard treatment for severe symptomatic aortic stenosis.
• Increasing patient age and comorbidities elevate surgical risks, necessitating alternative treatments.

Purpose:

• To review the current status of transcatheter aortic valve implantation (TAVI) as an alternative to surgical aortic valve replacement.
• To discuss the transfemoral and transapical approaches for TAVI.
• To highlight the need for further research to establish TAVI's long-term efficacy and indications.

Summary:

• Transcatheter aortic valve implantation (TAVI) has emerged as a viable alternative to surgical aortic valve replacement, particularly for elderly patients with severe aortic stenosis and high surgical risk.
• The main TAVI approaches include transfemoral (retrograde) and transapical (antegrade) routes.
• While initial TAVI results are promising, conventional surgery remains the standard due to limited long-term data. Patient-specific risk profiles guide treatment selection.

Impact:

• TAVI provides a less invasive treatment option for patients unsuitable for traditional surgery.
• Further randomized trials are crucial to determine the long-term survival benefits of TAVI across different risk populations.
• Optimal patient selection based on individual risk assessment is key for successful TAVI outcomes.