Abstract:

Transcatheter aortic valve implantation (TAVI) is a truly minimally invasive technique allowing for off-pump aortic valve implantation in selected high-risk patients. Potential advantages are the avoidance of cardiopulmonary bypass, aortic cross-clamping, and sternotomy. Feasibility has been proven for a retrograde transfemoral, retrograde trans-subclavian, and antegrade trans-apical approach. Superiority of one of these delivery routes is as yet unproven. Given the excellent outcome following conventional aortic valve replacement even in octogenarians and the lack of prospectively randomized trials proving the effectiveness of TAVI, this new innovative technique should be restricted to selected high-risk patients at present. Nevertheless, TAVI has already evolved into a routine procedure in selected specialized centers providing a safe and reproducible treatment option for high-risk elderly patients suffering from severe symptomatic aortic stenosis.

Authors:

Jörg Kempfert, M.D., Resident, Heart Center, University of Leipzig, Clinic for Cardiac Surgery, Leipzig, Germany, Sven Lehmann, M.D., Consultant, Heart Center, University of Leipzig, Clinic for Cardiac Surgery, Leipzig, Germany, Axel Linke, M.D., Ph.D., Consultant, Heart Center, University of Leipzig, Clinic for Cardiology, Leipzig, Germany, Ardawan Rastan, M.D., Ph.D., Consultant, Heart Center, University of Leipzig, Clinic for Cardiac Surgery, Leipzig, Germany, Arnaud Van Linden, M.D., Resident, Heart Center, University of Leipzig, Clinic for Cardiac Surgery, Leipzig, Germany, Johannes Blumenstein, M.D., Resident, Heart Center, University of Leipzig, Clinic for Cardiac Surgery, Leipzig, Germany, Gerhard Schuler, M.D., Ph.D., Chief, Heart Center, University of Leipzig, Clinic for Cardiology, Leipzig, Germany, Friedrich W. Mohr, M.D., Ph.D., Chief, Heart Center, University of Leipzig, Clinic for Cardiac Surgery, Leipzig, Germany, Thomas Walther, M.D., Ph.D., Consultant, Heart Center, University of Leipzig, Clinic for Cardiac Surgery, Leipzig, Germany

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