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Open issues in transcatheter aortic valve implantation. Part 1: patient selection and treatment strategy for transcatheter aortic valve implantation.

Authors
  • Bax, Jeroen J
  • Delgado, Victoria
  • Bapat, Vinayak
  • Baumgartner, Helmut
  • Collet, Jean P
  • Erbel, Raimund
  • Hamm, Christian
  • Kappetein, Arie P
  • Leipsic, Jonathon
  • Leon, Martin B
  • MacCarthy, Philip
  • Piazza, Nicolo
  • Pibarot, Philippe
  • Roberts, William C
  • Rodés-Cabau, Josep
  • Serruys, Patrick W
  • Thomas, Martyn
  • Vahanian, Alec
  • Webb, John
  • Zamorano, Jose Luis
  • And 1 more
Type
Published Article
Journal
European Heart Journal
Publisher
Oxford University Press
Publication Date
Oct 07, 2014
Volume
35
Issue
38
Pages
2627–2638
Identifiers
DOI: 10.1093/eurheartj/ehu256
PMID: 25062952
Source
Medline
Keywords
License
Unknown

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.

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