Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Abstract

Aims To critically review the available transcatheter aortic valve implantation techniques and their results, as well as propose recommendations for their use and development. Methods and results A committee of experts including European Association of Cardio-Thoracic Surgery and European Society of Car-diology representatives met to reach a consensus based on the analysis of the available data obtained with transcath-eter aortic valve implantation and their own experience. The evidence suggests that this technique is feasible and provides haemodynamic and clinical improvement for up to 2 years in patients with severe symptomatic aortic ste-nosis at high risk or with contraindications for surgery. Questions remain mainly concerning safety and long-term durability, which have to be assessed. Surgeons and cardiologists working as a team should select candidates, perform the procedure, and assess the results. Today, the use of this technique should be restricted to high-risk patients or those with contraindications for surgery. However, this may be extended to lower risk patients if the initial promise holds to be true after careful evaluation. * Corresponding authors. Tel: þ33 1 40 25 67 60, Fax: þ33 1 40 25 67 32, Email: alec.vahanian@bch.aphp.fr (A. V.);

Evolution of Cognitive Function After Transcatheter Aortic Valve Implantation

“…[1][2][3][4][5][6][7] Consequently, most patients undergoing TAVI are old and have multiple comorbidities. [1][2][3][4][5][6][7][8][9] In these patients, functional aspects, especially cognitive function, are highly relevant.…”

Transcatheter aortic valve implantation in an orthotopic heart transplant recipient with bicuspid aortic valve

“…TAVI, however, showed more frequent paravalvular regurgitation and increased late mortality 7, 9. Although TAVI has been limited to high‐risk and inoperable patients, carefully selected younger patients may benefit from this approach if advantages of the TAVI outweigh the results expected from conventional SAVR 10. HTx recipients with aortic valve disease may be considered eligible candidates for TAVI because of patient‐specific and procedure‐specific features.…”

Transcatheter aortic valve implantation

“…In patients without indications for chronic anticoagula tion, dual antiplatelet therapy is used to prevent thrombosis of the aortic valve prosthesis for 1-6 months after TAVI, using daily maintenance doses of 75-100 mg of ASA (continued indefinitely) and 75 mg of clopidogrel (for up to six months) [28][29][30][31][32][33][34][35].…”