[Aortic stenosis: TAVI for all patients?]
Sarah Mauler-WittwerMarc ArcensStephane NoblePublished in: Revue medicale suisse (2023)
Over the last 21 years, the paradigm has shifted from an initial use of TAVI for inoperable aortic stenosis cases to recognition of its benefits for all categories of patients. Since 2021, the European Society of Cardiology has recommended first-line transfemoral TAVI from the age of 75 for all categories of patients with aortic stenosis (high, intermediate, low risk). However, in Switzerland, the Federal Office of Public Health currently places a restriction on the reimbursement of low-risk patients, which is expected to be reassessed in 2023. Surgery remains the best therapeutic option for patients with an unfavorable anatomy and for those whose life expectancy exceeds the potential durability of the valve. In this article we will discuss the evidence supporting TAVI, its current indications and initial complications as well as areas for improvement to potentially further expand its indications.
Keyphrases
- aortic stenosis
- ejection fraction
- transcatheter aortic valve implantation
- transcatheter aortic valve replacement
- aortic valve replacement
- aortic valve
- left ventricular
- public health
- end stage renal disease
- coronary artery disease
- newly diagnosed
- chronic kidney disease
- squamous cell carcinoma
- peritoneal dialysis
- risk assessment
- mitral valve
- risk factors