Percutaneous Aortic Valve Implantation

Trans catheter aortic valve implantation (TAVI) is rapidly gaining acceptance in the treatment of severe aortic valve stenosis in the elderly. The technique is especially beneficial for patients, where surgical aortic valve replacement is indicated but is associated with a prolonged reduction concerning quality of life. The indication for TAVI should be restricted to such patients, since mortality in the high-risk population treated so far with TAVI was found to be close to 10% at 30 days. In addition reliable long-term data beyond 2 years are missing for the currently available devices. Therefore TAVI should currently be restricted to patients older than 75 years that present with an STS score of > 10 or a logEuroScore of > 20. Currently, patients with a life expectancy of less than 1 year or an aortic annulus of < 18 mm or > 27 mm should not be treated with TAVI. Ongoing studies will shortly provide an even more solid base concerning safety, efficacy and long-term results in large patient cohorts treated with TAVI. The technical and scientific development in this field warrants continuous readjustments concerning the value of TAVI in the treatment of aortic stenosis; currently all available data point to an increasing role of these techniques in the treatment of aortic stenosis.