TAVI is a safe alternative to redo cardiac surgery for failing bioprosthetic valves, according to research presented at the ESC Congress today by Dr Spyridon Katsanos from The Netherlands. The findings suggest that transcatheter aortic valve implantation (TAVI) is a treatment alternative for inoperable elderly patients and high risk patients with failing bioprostheses.
Use of bioprosthetic heart valves has dramatically increased (from 18% in 1991 to 59% in 2003), mainly in older patients with comorbidities. This is due to the increased risk of bleeding complications associated with lifelong use of anticoagulation for mechanical prostheses.
But structural valve deterioration is one the main complications associated with bioprosthetic heart valves. In large registries including more than 300 000 patients undergoing aortic valve replacement the reoperation rate for patients receiving a bioprosthesis was 3.1% at 11-13 years of follow-up compared with 2.3% reoperation rate for recipients of an aortic mechanical prosthesis.1
Dr Katsanos said: