The content of these European Society of Cardiology (ESC) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC Guidelines may be translated or reproduced in any form without written permission from the ESC. Permission can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC. Disclaimer:The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and, where appropriate and/or necessary, the patient's caregiver. Nor do the ESC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

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Background-To evaluate initial multicenter results with minimally invasive transapical aortic valve implantation (TAP-AVI) for high risk patients with aortic stenosis. Methods and Results-TAP-AVI was performed via a small anterolateral minithoracotomy with or without femorofemoral extracorporeal circulation (ECC) on the beating heart. A pericardial xenograft fixed within a stainless steel, balloon expandable stent (Edwards SAPIEN THV, Edwards Lifesciences) was used. Fifty-nine consecutive patients (81Ϯ6 years, 44 female) were operated on from 02/06 until 10/06 at 4 centers using fluoroscopic and echocardiographic visualization. Average EuroSCORE predicted risk for mortality was 27Ϯ14%. TAP valve positioning was performed successfully in 53 patients, 4 required early conversion to sternotomy. Implantation (23-mm valves in 19 and 26-mm valves in 40 patients) was performed on the beating heart during brief periods of rapid ventricular pacing. Thirty-one patients were operated on without cardiopulmonary bypass. Neither coronary artery obstruction nor migration of the prosthesis was observed, and all valves had good hemodynamic function. Echocardiography revealed minor paravalvular leakage in 26 patients (trace in 11, mild in 12, and severe in 3). Eight patients died in-hospital (13.6%) without any valve dysfunction. Actuarial survival was 75.7Ϯ5.9% at a follow-up interval of 110Ϯ77 days (range 1 to 255 days). Conclusions-TAP-AVI can be performed safely with good early results in high risk patients. Long-term valve performance as well as broader based applications of this promising approach will need to be studied.

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Рабочая группа по диагностике и лечению гипертрофической кардиомиопатии Европейского общества кардиологов (ESC)Авторы/члены рабочей группы: perry M. Elliott* (Председатель) (великобритания) Aris Anastasakis (Греция), Michael A. borger (Германия), Martin borggrefe (Германия), Franco Cecchi (Италия), philippe Charron (Франция), Albert Alain Hagege (Франция), Antoine Lafont (Франция), Giuseppe Limongelli (Италия), Heiko Mahrholdt (Германия), William J. McKenna (великобритания), Jens Mogensen (дания), petros Nihoyannopoulos (великобритания), Stefano Nistri (Италия), petronella G. pieper (Нидерланды), burkert pieske (Австрия), Claudio Rapezzi (Италия), Frans H. Rutten (Нидерланды), Christoph Tillmanns (Германия), Hugh Watkins (великобритания). Дополнительный участник: Constantinos O'Mahony (великобритания).Комитет ESC по подготовке практических рекомендаций (КПР): Jose Luis Zamorano (Председатель) (Испания), Stephan Achenbach (Германия), Helmut baumgartner (Германия), Jeroen J. bax (Нидерланды), Héctor bueno (Испания), Veronica Dean (Франция), Christi Deaton (великобритания), Çetin Erol (Турция), Robert Fagard (Бельгия), Roberto Ferrari (Италия), David Hasdai (Израиль), Arno W. Hoes (Нидерланды), paulus Kirchhof (Германия/великобритания), Juhani Knuuti (Финляндия), philippe Kolh (Бельгия), patrizio Lancellotti (Бельгия), Ales Linhart (Чехия), petros Nihoyannopoulos (великобритания), Massimo F. piepoli (Италия), piotr ponikowski (Польша), per Anton Sirnes (Норвегия), Juan Luis Tamargo (Испания), Michal Tendera (Польша), Adam Torbicki (Польша), William Wijns (Бельгия), Stephan Windecker (Швейцария).Рецензенты: David Hasdai (Израиль) (КПР координатор рецензирования), piotr ponikowski (Польша) (КПР координатор рецензирования), Stephan Achenbach (Германия), Fernando Alfonso (Испания), Cristina basso (Италия), Nuno Miguel Cardim (Португалия), Juan Ramón Gimeno (Испания), Stephane Heymans (Нидерланды), per Johan Holm (Швеция), Andre Keren(Израиль), paulus Kirchhof (Германия/великобритания), philippe Kolh (Бельгия), Christos Lionis (Греция), Claudio Muneretto (Италия), Silvia priori (Италия), Maria Jesus Salvador (Испания), Christian Wolpert (Германия), Jose Luis Zamorano (Испания).Формы раскрытия конфликта интересов авторов и рецензентов рекомендаций доступны на сайте ESC www.escardio.org/guidelines

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