The future of new aortic valve replacement approaches.
Aortic valve disease is a growing cause of mortality and morbidity, especially in developed countries. Whereas medical therapy is associated with an ominous prognosis, since the 1970s, surgical valve replacement has represented a standard therapy for fit patients. Indeed, this approach is safe and feasible in younger patients without comorbidities. However, in unfit patients, surgery may be associated with a very high risk. The advent of transcatheter valve replacement techniques, by means of percutaneous or transapical approaches, has been recently introduced into mainstream clinical practice and is likely to radically change the treatment of aortic valve disease. At present, further data are needed to thoroughly appraise the long-term risk-benefit balance of transcatheter valve replacement techniques. For this reason, it can only be considered for high surgical risk patients, but early results are so promising that in the future, transcatheter aortic valve implantation could became the first therapeutic choice, even for low-risk patients.
Bollati
Mario
M
Division of Cardiology, University of Torino, Corso Bramante 88-90, 10126 Torino, Italy.
Tizzani
Emanuele
E
Moretti
Claudio
C
Sciuto
Filippo
F
Omede
Pierluigi
P
Zoccai
Giuseppe Biondi
GB
Trevi
Gian Paolo
GP
Abbate
Antonio
A
Sheiban
Imad
I
D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001705:Bioprosthesis; D002404:Catheterization; D002986:Clinical Trials as Topic; D003952:Diagnostic Imaging; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D018579:Patient Selection; D011474:Prosthesis Design