Zwężenie zastawki aortalnej i nowoczesne metody jej leczenia

Abstrakt

Aortic stenosis is the most common acquired valvular heart disease. Aortic stenosis has growing prevalence in people older than 75 years and natural course of disease is characterized by high mortality rate. According to epidemiological data all patients with aortic stenosis will die after 2–5 years from the first signs of disease if not undergo aortic valve replacement. However, even 40% of patients do not have surgery because of comorbidities related to advanced age. This was the main reason why in 80- and 90-ties of XX century there were intensive attempt to developed an alternative, less invasive treatment methodology for people with aortic stenosis and comorbidities and at high surgical risk. Transcatheter aortic valve implantation (TAVI) was introduced by Dr Alain Cribier in February 2nd, 2002 in Rouen, France. Since that day different aortic transcatheter bioprostheses were used in many randomized clinical trials comparing their safety and effectiveness versus surgical aortic valve replacement. Gradually, it became clear that in all older patients in all risk groups TAVI was equally or even more safe and effective than surgery. Complications after TAVI are relatively rare, but some of them are life-threatening. Heart Team plays a key role in patients selection to TAVI.