Transcatheter aortic valve replacement in elderly patients

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Dimytri Siqueira(Institute Dante Pazzanese of Cardiology, Av. Dr Dante Pazzanese, 500 Ibirapuera, S(a)o Paulo, CEP 04012080, Brazil)
Alexandre Abizaid(Institute Dante Pazzanese of Cardiology, Av. Dr Dante Pazzanese, 500 Ibirapuera, S(a)o Paulo, CEP 04012080, Brazil)
Magaly Arrais J.(Institute Dante Pazzanese of Cardiology, Av. Dr Dante Pazzanese, 500 Ibirapuera, S(a)o Paulo, CEP 04012080, Brazil)
Eduardo Sousa(Institute Dante Pazzanese of Cardiology, Av. Dr Dante Pazzanese, 500 Ibirapuera, S(a)o Paulo, CEP 04012080, Brazil;Heart Hospital, Rua Desembargador Eliseu Guilherme, 147 Paraíso S(a)o Paulo, CEP 040004030, Brazil)
Journal Title:
Volume 09, Issue 02, 2012
Key Word:
Aortic stenosis;Elderly patients;Transcatheter aortic valve replacement;Percutaneous valve therapies

Abstract: Aortic stenosis is the most common native valve disease, affecting up to 5% of the elderly population. Surgical aortic valve replacement reduces symptoms and improves survival, and is the definitive therapy in patients with symptomatic severe aortic stenosis. However, despite the good results of classic surgery, risk is markedly increased in elderly patients with co-morbidities. Transcatheter aortic valve replacement (TAVR) allows implantation of a prosthetic heart valve within the diseased native aortic valve without the need for open heart surgery and cardiopulmonary bypass, offering a new therapeutic option to elderly patients considered at high surgical risk or with contraindications to surgery. To date, several multicenter registries and a randomized trial have confirmed the safety and efficacy of TAVR in those patients. In this chapter, we review the background and clinical applications of TAVR in elderly patients.

  • [1]Nkomo VT,Gardin JM,Skelton TN,et al.Burden of valvular heart diseases:a population-based study.Lancet 2006;368:1005–1011.
  • [2]Bonow RO,Carabello BA,Chatterjee K,et al.2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.Circulation 2008;118:E523–E661.
  • [3]Iung B,Baron G,Butchart EG,et al.A prospective survey of patients with valvular heart disease in Europe:the Euro Heart Survey on valvular heart disease.Eur Heart J 2003;24:1231–1243.
  • [4]Cribier A,Eltchaninoff H,Bash A,et al.Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis:first human case description.Circulation 2002;106:3006–3008.
  • [5]Serruys PW,Morice MC,Kappetein AP,et al.Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease.N Engl J Med 2009;360:961–972.
  • [6]Holmes Jr DR,Mack MJ.Transcatheter Valve Therapy:A Professional Society Overview from the American College of Cardiology Foundation and the Society of Thoracic Surgeons.J Am Coll Cardiol 2011;58:445–455
  • [7]Rodés-Cabau J,Webb JG,Cheung A,et al.Transcatheter aortic valve implantation for the treatment of severe symptomatic aortic stenosis in patients at very high or prohibitive surgical risk.Acute and late outcomes of the multicenter Canadian experience.J Am Coll Cardiol 2010;55:1080–1090.
  • [8]Thomas M,Schymik G,Walther T,et al.Thirty-day results of the SAPIEN aortic bioprosthesis European outcome (SOURCE) registry:a European registry of transcatheter aortic valve implantation using the Edwards SAPIEN valve.Circulation 2010;122:62–69.
  • [9]Eltchaninoff H,Prat A,Gilard M,et al.Transcatheter aortic valve implantation:early results of the FRANCE (FRench Aortic National CoreValve and Edwards) registry.Eur Heart J 2011;32:191–197.
  • [10]Moat N,Ludman P,de Belder MA,et al.Long-term outcomes after transcatheter aortic valve implantation in high-risk patients with severe aortic stenosis.The UK TAVI (United Kingdom Transcatheter Aortic Valve Implantation) registry.J Am Coll Cardiol 2011;58:2130–2138.
  • [11]Leon MB,Smith CR,Mack MJ,et al.Transcatheter aorticvalve implantation for aortic stenosis in patients who cannot undergo surgery.N Engl J Med 2010;363:1597–1607.
  • [12]Smith CR,Leon MB,Mack MJ,et al.Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk Patients.N Engl J Med 2011;364:2187–2198.
  • [13]Clavel MA,Webb JG,Rode′s-Cabau J,et al.Comparison between transcatheter and surgical prosthetic valve implantation in patients with severe aortic stenosis and reduced left ventricular ejection fraction.Circulation 2010;122:1943–1951.
  • [14]Tamburino C,Capodanno D,Ramondo A,et al.Incidence and Predictors of Early and Late Mortality After Transcatheter Aortic Valve Implantation in 663 Patients With Severe Aortic Stenosis.Circulation 2011;123;299–308.
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