title: [Aortic valve stenosis: transcatheter aortic valve implantation (TAVI) – transarterial or transapical approach].
abstract: The calcified aortic stenosis is the dominating valve disease. Patients affected are most common elderly people in the 8 (th) or 9 (th) decade of their life who often show associated comorbidities like reduced left ventricular function, impaired renal function, pulmonary hypertension, and further diseases (Diabetes mellitus, stroke, COPD). In many cases perioperative morbidity and mortality are too high for surgical valve replacement and up to 30 % of patients are rejected. Nevertheless, prognosis of aortic stenosis is worse if the typical symptoms like dyspnea on exertion, syncope, and angina occur. The transcatheter aortic valve implantation is a new method treating this particular group of patients. The aortic valve bioprothesis consists of a balloon-expandable stent or a self-expandable frame, in which a valve of bovine or porcine pericardium is incorporated. The implantation is performed by retrograde access via the femoral or subclavian artery; the balloon-expandable prosthesis can also be implanted by transapical approach. Recently, the PARTNER trial and other studies demonstrate a high implantation success rate and better survival in comparison to standard therapy but exhibit also cerebral vascular and peripheral vascular complications. A further reduction of the available delivery systems and new types of valves which are under experimental tests and clinical evaluation contribute to this development.
authors.affiliation: Klinik für Kardiologie, Pneumologie, Internistische Intensivmedizin und Zentrale Notaufnahme, Sektion Innere Medizin, Klinikum Schwabing, Städtisches Klinikum München GmbH, München. stefan.sack@klinikum-muenchen.de
authors.forename: S
authors.initials: S
authors.lastname: Sack
authors.forename: M K
authors.initials: MK
authors.lastname: Schelp
authors.forename: S
authors.initials: S
authors.lastname: Poppe
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.forename: T
authors.initials: T
authors.lastname: Krüger
authors.forename: S
authors.initials: S
authors.lastname: Geith
authors.forename: M
authors.initials: M
authors.lastname: Lieber
authors.forename: S
authors.initials: S
authors.lastname: Schleger
authors.forename: W
authors.initials: W
authors.lastname: Eichinger
authors.forename: J
authors.initials: J
authors.lastname: Menne
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography; D001705:Bioprosthesis; D002114:Calcinosis / Q000175:diagnosis / Q000601:surgery*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D002404:Catheterization; D003299:Cooperative Behavior; D004417:Dyspnea / Q000209:etiology; D004452:Echocardiography; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D033183:Interdisciplinary Communication; D010166:Palliative Care; D011183:Postoperative Complications / Q000175:diagnosis; D011474:Prosthesis Design