Mid-term follow-up after transcatheter aortic valve implantation

Abstract

This editorial refers to ‘Transcatheter aortic valve implantation: 3-year outcomes of self-expanding CoreValve prosthesis’[†][1], by G.P. Ussia et al. , on page 969 The prognosis for patients with symptomatic aortic stenosis is poor. Although open surgical aortic valve replacement (SAVR) is the gold standard for the management of aortic stenosis, there are no randomized trials or formal evaluations of the sort that would currently be the norm to gain approval of such a costly and invasive treatment. However, like the use of parachutes when jumping from airplanes, randomized trials were presumably considered unnecessary. There is no doubt that SAVR can relieve symptoms and prolong life. With surgery already offering a tried and true option for patients with aortic stenosis, it is reasonable to expect more rigorous evaluation of transcatheter aortic valve implantation (TAVI).1 Ussia et al. now report 3-year outcomes following CoreValve implantation from a large and well compiled Italian registry.2 In light of this and other recent studies,3–5 it may be helpful to review what we now know about some of the early concerns about TAVI that are gradually being addressed. Concerns such as: (i) aortic stenosis might not be adequately relieved by transcatheter valves; (ii) paravalvular leaks might have serious consequences; (iii) durability might be poor; and (iv) the TAVI procedure might be inherently more dangerous than SAVR. Is transcatheter … [1]: #fn-2