Abstract
Background: Patients with severe valvular heart disease associated with significant comorbidities have a high risk to undergo conventional surgical replacement procedures. Alternative catheter-based endovascular interventions have recently been developed to treat such a group of patients.Aim: To review the indications, short- and long-term outcome, success rate and complications of transcatheter aortic valve implantation (TAVI).Materials and method: A case with severe aortic stenosis and significant comorbidities is presented and the literature is reviewed regarding the currently applied TAVI.Results: Presented is a 63-year man with severe aortic valve stenosis and significant concomitant disorders including diabetes, multifactorial anaemia, chronic renal impairment, chronic obstructive pulmonary disorder, peripheral arterial disease and bilateral renal carcinoma. The patient was eligible for TAVI but had inaccessible vascular approach. Transapical and transaortic access were excluded because of poor respiratory function. Medical treatment was continued. Recent data from international literature showed that the success rate of TAVI varied from 83.1% to 100%, complications such as vascular and conduction disorders were between 3.3-18% and 0-34.4%, respectively and the reported 30-day mortality rate ranged from 0% to15.2% in different series.Conclusions: Our patient with severe aortic stenosis and significant comorbidities had a high-risk for conventional aortic valve replacement and was inaccessible for TAVI. He remained on medical treatment. The TAVI procedure in eligible patients is safe and efficacious with not infrequent procedure-related complications due to advanced age, pre-existent poor conditions of respiratory and renal systems and co-morbidities of the selected subjects.
Highlights
Aortic valvular stenosis is the most common valvular heart disease (VHD) in adult population [1]
Surgical aortic valve replacement is the treatment of choice in patients with severe aortic stenosis [3] which is associated with low morbidity and mortality
It has been reported that one-year survival rate of unoperated patients with aortic valvular stenosis is estimated at 60% [14]
Summary
Aortic valvular stenosis is the most common valvular heart disease (VHD) in adult population [1]. Conventional treatment of choice for VHD in ageing population is surgical valve replacement [2] which is associated with relief of symptoms and a high survival rate. Surgical aortic valve replacement is the treatment of choice in patients with severe aortic stenosis [3] which is associated with low morbidity and mortality. Comparison between transcatheter aortic valve implantation (TAVI) and medical therapy has learned that at oneyear follow-up, the mortality rate from any cause was lower (30.7%) in the TAVI group as compared with 50.7% in the conventionally treated group [11]. It has been reported that one-year survival rate of unoperated patients with aortic valvular stenosis is estimated at 60% [14]. Patients with severe valvular heart disease associated with significant comorbidities have a high risk to undergo conventional surgical replacement procedures. Alternative catheter-based endovascular interventions have recently been developed to treat such a group of patients
Sign-in/Register to view highlights & summary 
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call