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Vol. 72. Issue 8.
Pages 664-671 (August 2019)
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Vol. 72. Issue 8.
Pages 664-671 (August 2019)
Review article
DOI: 10.1016/j.rec.2019.02.009
Future Directions. Transcatheter Aortic Valve Implantation for Low-risk Patients: Inevitable Evolution or a Step Too Far?
Perspectivas futuras. Implante percutáneo de válvula aórtica para pacientes en bajo riesgo: ¿una realidad a corto plazo o se debe esperar?
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Guy Witberg
Corresponding author
guy.witberg@gstt.nhs.uk

Corresponding author: Department of Cardiology, St Thomas’ Hospital, Westminster Bridge Road, SE1 7EH London, United Kingdom.
, Tiffany Patterson, Simon Redwood, Bernard Prendergast
Department of Cardiology, St Thomas’ Hospital, London, United Kingdom
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Table 1. Randomised Clinical Trials of TAVI vs SAVR in Low Surgical Risk Patients
Abstract

Transcatheter aortic valve replacement has become the treatment of choice for inoperable and high-risk patients with symptomatic aortic stenosis, and is becoming more and more common as the first choice for intermediate-risk patients as well. The next step in this evolution would be the expansion of treatment indications to low-risk patients. Successful treatment of this patient population will require setting new standards in terms of clinical outcomes and cost effectiveness. In this review, we present the main challenges that need to be addressed before transcatheter aortic valve replacement can be applied as a standard treatment for low-risk patients.

Keywords:
Aortic stenosis
Transcatheter aortic valve replacement
Abbreviations:
AS
CAD
PPM
PVL
SAVR
SVD
TAVI
Resumen

El implante percutáneo de válvula aórtica es actualmente el tratamiento de elección para los pacientes con estenosis aórtica sintomática grave inoperables o con alto riesgo quirúrgico, y su uso cada vez es más habitual para los pacientes con riesgo intermedio. El siguiente paso en esta evolución sería la indicación para los pacientes con bajo riesgo quirúrgico. El tratamiento exitoso de esta población de pacientes requerirá la definición de resultados clínicos y de coste-efectividad adaptados a ella. En esta revisión se presentan los principales obstáculos que se deberá superar antes de que el implante percutáneo de válvula aórtica sea aplicable como el tratamiento habitual para pacientes con bajo riesgo.

Palabras clave:
Estenosis aórtica
Implante percutáneo de válvula aórtica

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