Transcatheter aortic valve implantation (TAVI) –  current situation and news in 2013

Authors: V. Kočka;  P. Toušek
Authors‘ workplace: Kardiocentrum, FN Královské Vinohrady
Published in: Kardiol Rev Int Med 2013, 15(3): 149-152


Transca­theter aortic valve implantation (TAVI) as a new but now widely accepted method has become a routine part of modern interventional cardiology. Our review article will at first introduce the design of the two currently approved and dominant valve prostheses. We present a comparison of patient characteristics and results between the early phase (Partner study) and current situation (recently published in the Sentinel registry). In 2013, there are several new approaches and the importance of CT based evaluation of aortic annulus size and the safest vascular access are highlighted. There are two less common indications of TAVI technology –  so- called valve- in‑valve for therapy of degenerated aortic bio­prosthesis and the second indication is therapy of pure aortic regurgitation. We discuss the results as well as the risks. As far as long‑term results are concerned, preliminary data from a five‑year patient follow‑up and the results with this catheter based technology are very optimistic. We present the economic analysis of the Partner study performed in the USA and we have performed a preliminary comparison of in‑hospital costs between TAVI and surgical aortic valve replacement (AVR) within Czech healthcare –  it seems that the cost difference (once the price of post‑operative care is included) is not dramatic. The patient who, despite the recommendation of Heart Team prefers TAVI to AVR, presents an ethical dilemma. Can the patient make this choice? Finally, we briefly present our results of the TAVI programme in University Hospital Královské Vinohrady.

aortic stenosis –  transcatheter aortic valve implantation


1. 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.

2. 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.

3. Vojáček J. První katetrizační implantace aortálních chlopní v České republice. Interv Akut Kardiol 2009; 8: 43– 46.

4. Želízko M, Janek B, Malý J et al. Současné postavení a výsledky katetrizační léčby aortální stenózy a mitrální regurgitace. Cor Vasa 2011; 53: 25– 32.

5. Di Mario C, Eltchaninoff H, Moat N et al. The 2011– 12 pilot European Sentinel Registry of Trans­catheter Aortic Valve Implantation: in‑hospital results in 4,571 patients. EuroIntervention 2013; 8: 1362– 1371.

6. Hayashida K, Bouvier E, Lefevre T et al. Impact of CT- guided valve sizing on post‑procedural aortic regurgitation in transcatheter aortic valve implantation. EuroIntervention 2012; 8: 546– 555.

7. Dvir D, Webb J, Brecker S et al. Transcatheter aortic valve replacement for degenerative bio­prosthetic surgical valves: results from the global valve- in‑valve registry. Circulation 2012; 126: 2335– 2344.

8. Roy DA, Schaefer U, Guetta V et al. Transcatheter aortic valve implantation for pure severe native aortic valve regurgitation. J Am Coll Cardiol 2013; 61: 1577– 1584.

9. Toggweiler S, Humphries KH, Lee M et al. 5‑year outcome after transcatheter aortic valve implantation. J Am Coll Cardiol 2013; 61: 413– 419.

10. Reynolds MR, Magnuson EA, Lei Y et al. Cost‑effectiveness of transcatheter aortic valve replacement compared with surgical aortic valve replacement in high‑risk patients with severe aortic stenosis: results of the PARTNER (Placement of Aortic Transcatheter Valves) trial (Cohort A). J Am Coll Cardiol 2012; 60: 2683– 2692.

11. Reynolds MR, Magnuson EA, Wang K et al. Cost‑effectiveness of transcatheter aortic valve replacement compared with standard care among in­operable patients with severe aortic stenosis: results from the placement of aortic transcatheter valves (PARTNER) trial (Cohort B). Circulation 2012; 125: 1102– 1109.

Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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