[Aortic valve stenosis: from valvuloplasty to percutaneous heart valve].
Calcified aortic stenosis is the predominant valve disease. Patients affected are most commonly elderly people, who often show associated comorbidities like reduced left ventricular function, impaired renal function, and pulmonary hypertension. The risk of open-heart surgery is elevated. Balloon aortic valvuloplasty enables a reduction of symptoms, an increase in physical performance, and, therefore, an improved quality of life. However, a reduction in mortality cannot be reached with this method. New techniques and improved equipment induced a "revival" of balloon aortic valvuloplasty, which has been introduced almost 20 years ago. In addition, brachytherapy after balloon valvuloplasty has recently been investigated and represents an interesting approach to reduce early restenosis. The technical improvement of balloon valvuloplasty is the percutaneous heart valve, which is under present clinical investigation. The antegrade/transseptal and retrograde approaches are used, as is the transapical access to the left ventricle. Even if long-term results are not yet available and the procedures still require technical improvement, especially minimization of catheter size, percutaneous valve replacement is a new chapter in the treatment of the calcified aortic stenosis.
Sack
Stefan
S
Klinik für Kardiologie, Westdeutsches Herzzentrum Essen, Zentrum für Innere Medizin, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen. stefan.sack@uk-essen.de
Kahlert
Philip
P
Khandanpour
Sasan
S
Kordish
Igor
I
Budeus
Marco
M
Naber
Christoph
C
Philipp
Sebastian
S
Möhlenkamp
Stefan
S
Erbel
Raimund
R
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D001705:Bioprosthesis; D001918:Brachytherapy; D002114:Calcinosis / Q000601:surgery / Q000628:therapy; D002404:Catheterization / Q000379:methods*; D002986:Clinical Trials as Topic; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011788:Quality of Life; D012307:Risk Factors