title: [We carry out too many TAVI - contra].
abstract: Transcatheter aortic valve implantation (TAVI) is an established and approved procedure with an increasing implantation rate, whilst the number of surgical aortic valve replacements (SAVR) remained unchanged (AQUA data). This demonstrates that more patients who were unsuitable for SAVR were treated with TAVI. First randomized trials have shown a significant survival benefit for TAVI compared to conservative therapy (PARTNER B) and non-inferiority to SAVR in high-risk patients (PARTNER A). The US pivotal trials demonstrated even a significant survival benefit in TAVI patients compared to SAVR. The current 5-year data of the PARTNER trials demonstrate a long-term durability of the TAVI valves, which even have superior hemodynamic parameters. Increasing experience, optimization and evolution of the TAVI systems lead to better results and lower rates of complications and mortality, as was shown by the "real world data" from the German aortic valve registry (GARY). The analysis of the subgroups and also the Nordic aortic valve intervention (NOTION) study showed equivalent results for TAVI and SAVR in patients with intermediate and low risk. There is a trend to expand the indications to patients with intermediate risk and the currently ongoing large prospective and randomized trials SURTAVI and PARTNER II could provide greater clarity.
authors.affiliation: Herzzentrum, Med. Klinik I - Kardiologie, Universitätsmedizin Rostock, Rostock, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Yücel
authors.affiliation: Herzzentrum, Med. Klinik I - Kardiologie, Universitätsmedizin Rostock, Rostock, Deutschland. Hueseyin.Ince@vivantes.de.|Klinik für Innere Medizin - Kardiologie und konservative Intensivmedizin, Vivantes Klinikum im Friedrichshain und Vivantes Klinikum Am Urban, Berlin, Deutschland. Hueseyin.Ince@vivantes.de.
authors.forename: H
authors.initials: H
authors.lastname: Ince
authors.affiliation: Klinik für Innere Medizin - Kardiologie und konservative Intensivmedizin, Vivantes Klinikum im Friedrichshain und Vivantes Klinikum Am Urban, Berlin, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: D'Ancona
authors.affiliation: Herzzentrum, Med. Klinik I - Kardiologie, Universitätsmedizin Rostock, Rostock, Deutschland.|Klinik für Innere Medizin - Kardiologie und konservative Intensivmedizin, Vivantes Klinikum im Friedrichshain und Vivantes Klinikum Am Urban, Berlin, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Kische
authors.affiliation: Herzzentrum, Med. Klinik I - Kardiologie, Universitätsmedizin Rostock, Rostock, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Öner
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000401:mortality* / Q000601:surgery*; D019317:Evidence-Based Medicine; D005858:Germany / Q000453:epidemiology; D006350:Heart Valve Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D000069342:Medical Overuse; D011183:Postoperative Complications / Q000401:mortality* / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D015996:Survival Rate; D065467:Transcatheter Aortic Valve Replacement / Q000401:mortality* / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: Durability; Extended application; Risk groups; Surgical therapy; Transcatheter aortic valve replacement