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Aortic stenosis: expanding treatment options.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Lüscher, Thomas F. |
| Copyright Year | 2016 |
| Abstract | ![Graphic][1] Aortic stenosis has markedly increased in prevalence and incidence as the life expectancy of citizens of Western societies has increased substantially. Indeed, we learned that there are patients with high- gradient, low-flow low-gradient, and even paradoxical low-flow low-gradient aortic stenosis.1–3 While surgical valve replacement was the treatment of choice for decades,4 transcatheter aorrtic valve implantation or TAVI has become an increasingly safe, effective, and attractive treatment option in patients at high risk for surgery.5,6 A downside of, in particular, the first-generation TAVI valves is the relatively high prevalence of paravalvular leaks with impact on clinical outcome.7,8 However, as outlined by Fabian Nietlispach and colleagues from the University Heart Center in Zurich, Switzerland in the review ‘ Percutaneous paravalvular leak closure: chasing the chameleon ’,9 a catheter-based approach can also solve this problem. The authors note that paravalvular leaks occur after both surgical10 and transcatheter valve replacement or implantation, respectively. This can lead to haemolysis and heart failure, and may increase the risk of endocarditis. Recently, proper adjudication of such leaks has been well defined, setting the basis for proper management.11 Percutaneous closure has significantly less morbidity than re-operation and is therefore often the therapy of choice. Percutaneous paravalvular leak closure can make an important difference for patients and can improve patient prognosis. Whether and in what patient population TAVI is superior to surgical valve replacement remains an ongoing debate.12,13 In a FAST TRACK paper entitled ‘ Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of severe aortic stenosis: a meta-analysis of randomized trials ’, Stephan Windecker and colleagues from the University Hospital Bern in Switzerland14 note that in light of current evidence available from randomized trials, they aimed to compare the collective safety … [1]: /embed/inline-graphic-1.gif |
| Starting Page | 3483 |
| Ending Page | 3485 |
| Page Count | 3 |
| File Format | PDF HTM / HTML |
| DOI | 10.1093/eurheartj/ehw642 |
| PubMed reference number | 28062582 |
| Journal | Medline |
| Volume Number | 37 |
| Issue Number | 47 |
| Alternate Webpage(s) | https://watermark.silverchair.com/ehw642.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAbIwggGuBgkqhkiG9w0BBwagggGfMIIBmwIBADCCAZQGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMb2cliEDFLX522qpwAgEQgIIBZbC7ytfOa8eYjjO_r8PxKiCFp-E6wFegF7EnAbSJek3o3EWP9fSruHMPIT_FDIFnfDk54rnrMhTcjFiC0RzoUga-2B2dS6pKi2P3jImsh82J2pi9HqZukpB35V9q_8CeuApvKgf_NokwZIeQlkT88gEVpxVKb-5172EYbhQVrOm88aRbv9vu8iMDS-fNqxCHv7weME1fUhGQNSYOoCf7ml3LOUgb2S3RIZeksl6y3zu8v2Gwxh4ccC86O4eIqnQGBe9ZrMjbaj-mnjKEQRlDwkzGbkLcmAOInp7rqnInQa1W3Lyj6Ptce26L21fmXA2fpYgGYqAf5DaTwrbZd5EkDLER-L1LiuaYkTQYAldiRmtqE_SygjA0I4MVCSqBfPG-PrEpbq5vfbSmN_Oj_aDm3F45p2q3L2E8ppme3ypMgqx5_cYzCzog7rnPdbolnQiXc1BoO2ezbP07w6lmgiM2XSdS2hSiOw |
| Alternate Webpage(s) | https://doi.org/10.1093/eurheartj%2Fehw642 |
| Journal | European heart journal |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
