title: Open issues in transcatheter aortic valve implantation. Part 1: patient selection and treatment strategy for transcatheter aortic valve implantation.
abstract: An exponential increase in the use of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis has been witnessed over the recent years. The current article reviews different areas of uncertainty related to patient selection. The use and limitations of risk scores are addressed, followed by an extensive discussion on the value of three-dimensional imaging for prosthesis sizing and the assessment of complex valve anatomy such as degenerated bicuspid valves. The uncertainty about valvular stenosis severity in patients with a mismatch between the transvalvular gradient and the aortic valve area, and how integrated use of echocardiography and computed tomographic imaging may help, is also addressed. Finally, patients referred for TAVI may have concomitant mitral regurgitation and/or coronary artery disease and the management of these patients is discussed.
authors: Department of Cardiology, Leiden University Medical Center, Albinusdreef 2 2300 RC, Leiden, The Netherlands j.j.bax@lumc.nl.
authors: Jeroen J
authors: JJ
authors: Bax
authors: Department of Cardiology, Leiden University Medical Center, Albinusdreef 2 2300 RC, Leiden, The Netherlands.
authors: Victoria
authors: V
authors: Delgado
authors: Department of Cardiology and Cardiothoracic Surgery, St Thomas' Hospital, London, UK.
authors: Vinayak
authors: V
authors: Bapat
authors: Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany.
authors: Helmut
authors: H
authors: Baumgartner
authors: Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
authors: Jean P
authors: JP
authors: Collet
authors: Department of Cardiology, West-German Heart Center Essen, University Duisburg Essen, Essen, Germany.
authors: Raimund
authors: R
authors: Erbel
authors: Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany.
authors: Christian
authors: C
authors: Hamm
authors: Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Arie P
authors: AP
authors: Kappetein
authors: St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Jonathon
authors: J
authors: Leipsic
authors: Columbia University Medical Center, Center for Interventional Vascular Therapy, New York Presbyterian Hospital, New York, USA.
authors: Martin B
authors: MB
authors: Leon
authors: Cardiovascular Department, King's College Hospital, London, UK.
authors: Philip
authors: P
authors: MacCarthy
authors: Interventional Cardiology, McGill University Health Center, Montreal, Canada Cardiovascular Surgery, German Heart Center Munich, Bavaria, Germany.
authors: Nicolo
authors: N
authors: Piazza
authors: Quebec Heart and Lung Institute, Québec, Canada.
authors: Philippe
authors: P
authors: Pibarot
authors: Baylor Heart and Vascular Institute and the Departments of Internal Medicine (Division of Cardiology) and Pathology, Baylor University Medical Center, Dallas, TX, USA.
authors: William C
authors: WC
authors: Roberts
authors: Department of Cardiology, Laval University, Quebec, Canada.
authors: Josep
authors: J
authors: Rodés-Cabau
authors: Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Patrick W
authors: PW
authors: Serruys
authors: Department of Cardiology and Cardiothoracic Surgery, St Thomas' Hospital, London, UK.
authors: Martyn
authors: M
authors: Thomas
authors: Bichat Hospital, University Paris VII, Paris, France.
authors: Alec
authors: A
authors: Vahanian
authors: St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors: John
authors: J
authors: Webb
authors: Cardiac Imaging Department, University Hospital Ramon y Cajal, Madrid, Spain.
authors: Jose Luis
authors: JL
authors: Zamorano
authors: Department of Cardiology, Bern University Hospital, Bern, Switzerland.
authors: Stephan
authors: S
authors: Windecker
mesh_terms: D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D057791:Cardiac Imaging Techniques; D003324:Coronary Artery Disease / Q000150:complications; D006350:Heart Valve Prosthesis; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D018579:Patient Selection; D011474:Prosthesis Design; D018570:Risk Assessment; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000175:diagnosis; D018487:Ventricular Dysfunction, Left / Q000209:etiology
keywords: Aortic stenosis; Coronary artery disease; Imaging; Mitral regurgitation; Patient selection; Transcatheter aortic valve implantation