[Aortic stenosis in the elderly: surgery or TAVI. New European guidelines]

Ten years after the first-in-man case, TAVI is now considered as a valid treatment of aortic stenosis in European guidelines. The first step in patient evaluation is to confirm the severity of aortic stenosis and the presence of symptoms. It is of utmost importance to check the consistency between echocardiographic criteria and clinical findings. TAVI should be considered only when surgical aortic valve replacement is contraindicated or at high risk. The assessment of the operative risk relies on a multidisciplinary heart team, taking into account risk score but keeping in mind their limitations in high-risk patients. TAVI should not be considered in low- or intermediate-risk patients, except for inclusion in controlled clinical trials. The population of high-risk patients with aortic stenosis is already important and will increase in the future due to population ageing.