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[TAVI simplification: A focus].

M Akodad1, T Lefèvre2, Y Lounes3

  • 1Service de cardiologie, centre hospitalier universitaire Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France; PhyMed Exp, université de Montpellier, Inserm U1046, CNRS UMR 9214, 34295 Montpellier cedex 5, France.

Annales De Cardiologie Et D'Angeiologie
|November 1, 2019
PubMed
Summary
This summary is machine-generated.

Transcatheter Aortic Valve Replacement (TAVR) has transformed aortic stenosis treatment, becoming simpler and safer for low-risk patients. Rigorous patient selection is crucial for the success of these minimally invasive procedures.

Keywords:
Early dischargeMinimalistMinimalisteParcours de soinsPathwaySimplificationSortie précoceTAVI

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Transcatheter Aortic Valve Replacement (TAVR) emerged in 2002, significantly altering aortic stenosis management.
  • Global TAVR procedure volume has steadily increased, reflecting its growing importance.

Purpose of the Study:

  • To highlight the evolution and simplification of the TAVR procedure.
  • To emphasize the reduction in complications and improved safety profiles for lower-risk patients.
  • To underscore the necessity of careful patient selection for simplified TAVR.

Main Methods:

  • The study reviews the advancements and adaptations in TAVR techniques over time.
  • Focuses on the trend towards minimalist approaches, including local anesthesia and percutaneous access.
  • Discusses procedural simplifications like no-predilatation implantation and rapid pacing.

Main Results:

  • TAVR has evolved into a simplified procedure, increasingly performed under local anesthesia with percutaneous femoral or radial access.
  • Operator and team experience, coupled with technique evolution, has led to significantly reduced complications in lower-risk surgical patients.
  • The adoption of simplified TAVR techniques has revolutionized patient management worldwide.

Conclusions:

  • The "simplified" TAVR represents a major advancement in treating aortic stenosis.
  • Ensuring safety requires meticulous upstream patient selection for suitability in minimalist procedures.
  • Continued refinement of TAVR techniques promises further improvements in patient outcomes.