[Transcatheter aortic prothesis implantation for the treatment of severe aortic stenosis]

Pichon Riviere A, Augustovski F, Garcia Marti S, Glujovsky D, Alcaraz A, Lopez A, Bardach A, Ciapponi A
Record ID 32014000297
Spanish
Authors' objectives: To assess the available evidence on the efficacy, safety and coverage related aspects regarding the use transcatheter aortic valve prosthesis for severe aortic insufficiency treatment.
Authors' recommendations: For those patients at low or moderate surgical risk, surgical aortic valve replacement is the treatment of choice. For patients at high surgical risk or in those where surgery is not possible, there is no consensus on what the best conduct should be. The results of this report come mainly from two RCTs. One of these RCTs compared TAVI against conventional surgery in patients at high surgical risk and in this group TAVI did not prove to be better than conventional surgery, or even it could present a higher adverse event risk. Therefore, even for those cases at high surgical risk, surgery may continue to be the best alternative for many patients. For those cases where surgery is not a possible option or the patient rejects it, the options are medical treatment, balloon angioplasty or TAVI. The second RCT included in this report assessed TAVI in a group of patients who were not considered surgical candidates. In this study, the comparator was a group of patients who mainly underwent balloon valvuloplasty. The TAVI group presented better results, but their interpretation should be cautious since balloon valvuloplasty is now being questioned due to the uncertainty regarding its potential effectiveness and its adverse event profile. No conclusions can be drawn regarding post-BAV TAVI effectiveness since the results come from observational studies evaluated at short term. In summary, in those patients where conventional surgery is not possible, the available evidence does not allow to clarify what the best conduct should be.
Details
Project Status: Completed
Year Published: 2012
URL for published report: https://www.iecs.org.ar/home-ets/?cod_publicacion=1408&origen_publicacion=publicaciones
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Humans
  • Aortic Valve Stenosis
  • Heart Valve Prosthesis Implantation
Contact
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
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