login
Password reminder
Cardiovascular News
Contact the editor Visit Cardiovascular News Twitter feed Visit Cardiovascular News Facebook page
 

ESC sets consensus over TAVI


Friday, 02 Sep 2011 12:33

 

The annual meeting of the European Society of Cardiology, in Paris, has enhanced the status of TAVI as the “gold standard” for inoperable patients suffering from severe aortic stenosis. However, concerns about high rates of permanent pacemaker implantation after TAVI remain, specialists say. 


TAVI was introduced nearly 10 years ago as an alternative procedure with limited application but it has expanded significantly in the course of recent years. Despite its increasing popularity among physicians, however, haemodynamic performance and valve durability remain unknown.


Now, for the first time, data from 393 consecutive patients undergoing implantation of a CoreValve self-expandable prosthesis at the German Heart Centre in Munich, Germany, have been presented: they show a “sustained improvement of haemodynamic values” and no signs of early or “unexpected” deterioration of the valve at three-year of follow-up.

 

“We all know that any biological valve gets deteriorated after a certain period of time, would this be 10 or 12 years. We know exactly when this will occur to a traditional heart valve, but we do not know when this will occur to a transcatheter valve. Now we know that after three years the haemodynamic performance of transcatheter valves is unchanged,” Anke Optiz, co-investigator of the study, told Cardiovascular News.

 

Based on the societies guidelines, so far most of the TAVI registries have included patients with high logistic Euroscore (20% or higher). However data presented at ESC this year suggest that 100% procedural success is possible even in a patient population with lower logistic Euroscore. The prospective, single-centre data refer to a cohort of 177 patients who underwent implantation with the Edwards valve at the Rouen University Hospital, France, between May 2006 and January 2011.

 

“We examined the population with lower logistic Euroscore because we were under the impression that these patients reacted better to TAVI as they were younger and had fewer comorbidities,” said Matthieu Godin, co-investigator of the study. “The retrospective analysis showed absence of death at 30 days for this specific group of low-risk patients. This result was beyond our expectations,” he added. Despite this data, Godin noted, “we should never forget that conventional surgery remains the gold standard for the lower-risk patient population”.

 

The Rouen experience is not isolated. An increasing trend to include lower risk patients into TAVI registries has been observed across European countries in the last few years. But according to both cardiology and cardiac surgery specialists discussing TAVI at ESC, this should not become standard practice.

 

“We can say that TAVI is doing relatively well – better than conventional surgery – within a certain high-risk group. But it is difficult to say that TAVI will necessarily do better in the lower group as well, because we do not have evidence of better results with TAVI compared to conventional surgery in any trial, including the US PARTNER trial where TAVI results are extremely good,” Olaf Wendler, clinical director, Cardiothoracic Surgery, King’s College Hospital, London, UK, told Cardiovascular News. “That is why I think TAVI should focus on patients who would clearly benefit from this new treatment immediately.”




Add New Comment

Related Items


Most popular


European Union agrees new rules for approving medical devices and in vitro diagnostic medical devices
Tuesday, 31 May 2016
The Netherlands presidency of the European Council and representatives of the European Parliament have reached a political agreement on two draft regulations for medical devices. The new regulations ... European Union agrees new rules for approving medical devices and in vitro diagnostic medical devices

Karl-Heinz Kuck steps down from the ESC and EHRA after fraud conviction
Wednesday, 08 Jun 2016
Karl-Heinz Kuck has withdrawn his candidacy for president-elect of the European Society of Cardiology (ESC) and also resigned from board of the European Heart Rhythm Association (EHRA). This follows ... Karl-Heinz Kuck steps down from the ESC and EHRA after fraud conviction

Biotronik’s scaffold is now approved for use in Europe
Wednesday, 15 Jun 2016
Biotronik’s bioresorbable magnesium scaffold—Magmaris—is now CE mark approved, meaning it is now one of three bioresorbable scaffolds available on the European market (alongside Abbott Vascular’s A... Biotronik’s scaffold is now approved for use in Europe

Features


TAVI durability: A rose by any other name is still a rose
Wednesday, 20 Jul 2016
The data that Dvir presented at EuroPCR, as reported by Cardiovascular News, indicate that there is a significant increase in valve degeneration between five and seven years after a transcatheter ... TAVI durability: A rose by any other name is still a rose

Exploring the borders of TAVI
Monday, 11 Jul 2016
The NOTION 2 trial, which recently enrolled a 64-year-old female with Society of Thoracic Surgeon (STS) score 1.2% as its first patient, is comparing the use of TAVI with the use of surgical aortic ... Exploring the borders of TAVI

Profiles


James Blankenship
Wednesday, 08 Jun 2016
James Blankenship is the 2015–2016 president of SCAI and has been involved with designing and ... James Blankenship

Alexandra Lansky
Monday, 07 Mar 2016
Alexandra Lansky (Director, Heart and Vascular Clinical Research Program, Yale University School of ... Alexandra Lansky

Cardiac Rhythm News Vascular News Cardiovascular News Interventional News Spinal News NeuroNews
BIBA Medical BIBA MedTech Insights CX Symposium ilegx
Password Reminder

BIBA Medical, 526 Fulham Road, Fulham, London, SW6 5NR.
TEL: +44 (0)20 7736 8788 FAX: +44 (0)20 7736 8283 EMAIL: 
info@bibamedical.com
© BIBA Medical Ltd is a company registered in England and Wales with company number 2944429.
VAT registration number 730 6811 50.
Site Map | Terms and Conditions