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Percutaneous management of aortic stenosis in high‐risk patients
Author(s) -
Layland Jamie J,
Bell Brendan,
Mullany Dan,
Walters Darren L
Publication year - 2010
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2010.tb03616.x
Subject(s) - medicine , stenosis , percutaneous , cardiology , aortic valve stenosis , aortic valve , aortic valve replacement , population , clinical trial , surgery , environmental health
As the population ages, the prevalence of aortic stenosis is increasing. There is an unmet clinical need for the treatment of aortic stenosis in high‐risk patients, who are often older, frail and have multiple comorbidities. Percutaneous aortic valve replacement (PAVR) is a new and innovative technique for the management of high‐risk patients with aortic stenosis. There are currently two devices under evaluation in clinical trials in Australia: the CoreValve ReValving System and the Edwards SAPIEN valve. These devices are generally deployed retrogradely, mainly transfemorally or via the subclavian artery or, less commonly, transapically. Initial experience has been encouraging, with good short‐term outcomes. However, there is a lack of long‐term data. PAVR is presently only advocated for high‐risk older patients with symptomatic aortic stenosis. Where PAVR lies in the treatment algorithm for aortic stenosis will be determined by randomised controlled trials, but for now it offers a genuine treatment alternative for high‐risk patients.