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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Transcatheter aortic valve implantation: patient selection.
S Stortecky1, C J O'Sullivan, L Buellesfeld
1Department of Cardiology Swiss Cardiovascular Center Bern University Hospital, Bern, Switzerland - stephan.windecker@insel.ch.
Minerva Cardioangiologica
|October 8, 2013
Summary
Transcatheter aortic valve implantation (TAVI) offers survival benefits for severe aortic stenosis patients unsuitable for surgery. Patient selection for TAVI requires careful consideration beyond traditional risk scores, involving a Heart Team and advanced imaging.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Imaging
Background:
- Transcatheter aortic valve implantation (TAVI) is a key treatment for symptomatic severe aortic stenosis, addressing an unmet need.
- TAVI demonstrates improved survival versus medical therapy in non-surgical candidates and comparable outcomes to surgical aortic valve replacement (SAVR) in high-risk patients.
- Current TAVI use is restricted to elderly patients with comorbidities, complicating treatment decisions.
Purpose of the Study:
- To review patient selection strategies for TAVI.
- To discuss the role of the interdisciplinary Heart Team in TAVI decision-making.
- To highlight the importance of advanced imaging in TAVI patient assessment.
Main Methods:
- Review of clinical trials and guidelines on TAVI patient selection.
- Discussion of traditional risk score limitations in TAVI candidates.
- Emphasis on the integration of Heart Team clinical assessment and detailed imaging protocols.
Main Results:
- Traditional risk scores inadequately assess TAVI patient risk.
- Heart Team evaluation and comprehensive imaging are crucial for optimal TAVI candidate selection.
- Detailed imaging of the aortic valve, root, aorta, and vasculature is essential for procedural planning.
Conclusions:
- Effective TAVI patient selection necessitates a multidisciplinary approach.
- Advanced imaging complements clinical judgment and risk scores for successful TAVI procedures.
- This review provides insights into selecting appropriate patients for TAVI.
