Decision making in TAVI: Ensuring the best possible clinical outcomes based on the selection of patients and techniques

Rasha Al-Lamee, Ottavio Alfieri, Antonio Colombo

Research output: Contribution to journalArticle

Abstract

Severe aortic stenosis is associated with high mortality and morbidity. Furthermore, it is the most common valvular abnormality in the developed world. Many patients do not have conventional surgical aortic valve replacement as a result of advanced age and comorbidity. Transcatheter aortic valve implantation (TAVI) is a viable alternative in this patient group, and has been recommended in patients with high surgical risk. Current guidelines for preassessment and patient selection are based on the initial TAVI studies assessing short- and longer-term outcome following valve implantation and were introduced to improve procedural success. The choice of the specific valve and delivery method is also very important in determining the clinical outcome, and requires a thorough evaluation preprocedure. This article reviews the current recommended guidelines for patient selection for TAVI, and their applications and limitations in the context of current clinical practice. As experience in the field grows, TAVI is being considered in a larger patient cohort. It may be that current guidelines are too rigid as the techniques and outcomes are improving with the widespread application of the technique. However, it remains vital that all patients undergo meticulous preassessment to ensure that the short- and long-term outcomes of this procedure continue to improve.

Original languageEnglish
Pages (from-to)219-231
Number of pages13
JournalInterventional Cardiology
Volume2
Issue number2
DOIs
Publication statusPublished - Apr 2010

Keywords

  • delivery method selection
  • patient selection
  • transcatheter aortic valve implantation
  • valve selection

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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