Heart Teams for Aortic Valve Disease: The TAVI Revolution
Severe aortic valve stenosis is associated with poor prognosis without intervention. Surgical aortic valve replacement was the standard intervention until the advent of transcatheter aortic valve implantation in 2002. The last two decades witnessed a rapid evolution in decision-making, technology and techniques. Concurrently, patients with aortic stenosis are becoming increasingly more complex. A multidisciplinary “Heart Team” facilitates navigation through a complex and continually evolving decision-making environment. This chapter explores the history, composition, role, benefits, challenges, and future of the Heart Team evaluating aortic stenosis in general with specific anecdotes as it applies to the authors’ center: The University of Ottawa Heart Institute (UOHI) in Ottawa, Canada.
KeywordsAortic valve stenosis (AS) Surgical aortic valve replacement (SAVR) Transcatheter aortic valve implantation (TAVI) SYNTAX (Synergy Between PCI with Taxus and Cardiac Surgery) PARTNER (Placement of Aortic Transcatheter Valves)
- 10.Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Thorac Cardiovasc Surg. 2014;148(1):e1–e132.CrossRefGoogle Scholar
- 11.Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Barón-Esquivias G, Baumgartner H, et al. Guidelines on the management of valvular heart disease (version 2012): the joint task force on the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg. 2012;42(4):S1–44.CrossRefGoogle Scholar
- 19.Takeda A, Taylor SJ, Taylor RS, Khan F, Krum H, Underwood M. Clinical service organisation for heart failure. Cochrane Database Syst Rev. 2012;(9):CD002752.Google Scholar