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Author Spotlight: Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research
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[Aortic stenosis: An update]

P Guedeney1, J-P Collet1

  • 1Sorbonne université, ACTION Study Group, institut de cardiologie, Centre Hospitalier Universitaire Pitié-Salpêtrière, 47, boulevard de l'hôpital, 75013 Paris, France.

La Revue De Medecine Interne
|February 19, 2022
PubMed

Insights

Transcatheter aortic valve implantation (TAVI) is now the primary treatment for severe aortic stenosis due to favorable outcomes compared to surgery. Ongoing trials explore new preventive strategies for this common valvulopathy.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Aortic stenosis is a prevalent valvulopathy with high mortality and morbidity.
  • Current understanding of pathophysiological mechanisms is improving, but effective prevention is lacking.
  • Transcatheter aortic valve implantation (TAVI) has transformed treatment over the past decade.

Purpose of the Study:

  • To review the pathophysiological mechanisms of severe aortic stenosis.
  • To discuss ongoing randomized controlled trials targeting these mechanisms.
  • To outline indications for surgical or percutaneous aortic valve replacement and associated complications.

Main Methods:

  • Review of current literature on aortic stenosis pathophysiology.
  • Analysis of data from major randomized controlled trials comparing TAVI and surgical aortic valve replacement.
  • Description of procedural techniques and complication profiles for both TAVI and surgical valve replacement.

Main Results:

  • Transfemoral TAVI is now the first-line treatment for symptomatic severe aortic stenosis.
  • TAVI has demonstrated favorable results compared to surgical aortic valve replacement in large trials.
  • Indications for TAVI have expanded due to technique refinement and trial evidence.

Conclusions:

  • TAVI represents a significant advancement in managing severe aortic stenosis.
  • Further research is exploring preventive strategies and optimizing TAVI procedures.
  • Understanding complications is crucial for patient management after valve replacement.

Keywords:
Aortic bicuspid valveAortic valve stenosisBicuspidieRemplacement chirurgicalRétrécissement aortique calcifiéSurgical replacementTAVITAVR

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