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).
OBJECTIVE
To critically review the available transcatheter aortic valve implantation techniques and their results, as well as propose recommendations for their use and development.


RESULTS
A committee of experts including European Association of Cardio-Thoracic Surgery and European Society of Cardiology representatives met to reach a consensus based on the analysis of the available data obtained with transcatheter 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 stenosis 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.


CONCLUSIONS
Transcatheter aortic valve implantation is a promising technique, which may offer an alternative to conventional surgery for high-risk patients with aortic stenosis. Today, careful evaluation is needed to avoid the risk of uncontrolled diffusion.
Vahanian
Alec
A
Hôpital Bichat, Paris, France. alec.vahanian@bch.aphp.fr
Alfieri
Ottavio
O
Al-Attar
Nawwar
N
Antunes
Manuel
M
Bax
Jeroen
J
Cormier
Bertrand
B
Cribier
Alain
A
De Jaegere
Peter
P
Fournial
Gerard
G
Kappetein
Arie Pieter
AP
Kovac
Jan
J
Ludgate
Susanne
S
Maisano
Francesco
F
Moat
Neil
N
Mohr
Friedrich
F
Nataf
Patrick
P
Piérard
Luc
L
Pomar
José Luis
JL
Schofer
Joachim
J
Tornos
Pilar
P
Tuzcu
Murat
M
van Hout
Ben
B
Von Segesser
Ludwig K
LK
Walther
Thomas
T
D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods* / Q000592:standards; D005060:Europe; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000592:standards; D006801:Humans; D012955:Societies, Medical