European Heart Journal Advance Access published online on April 25, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn180
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org
Percutaneous aortic valve implantation. The demise of classical aortic valve replacement?
Cardiothoracic Surgery, University Hospital, 3000-075 Coimbra, Portugal
* Corresponding author. Tel: +351 239400418, Fax: +351 239829674, Email: antunes.cct.huc@sapo.pt
This editorial refers to ‘Contemporary surgical or percutaneous management of severe aortic stenosis in the elderly,’ by F. Descoutures et al., doi:10.1093/eurheartj/ehn081
| The first 150 words of the full text of this article appear below. |
The Paris group of Descoutures et al.1 describe their recent experience with percutaneous aortic valve implantation (PAVI). During a 7-month period they were referred 66 elderly patients (>70 years; mean 83 years) for treatment of severe aortic stenosis (AS). Thirty-nine of these (59%) were judged inoperable or ‘high risk’ for surgery. From this subgroup, 12 (31%) were submitted to PAVI and the remaining 27, who were deemed unsuitable for this procedure, were either treated medically (16 patients) or had a catheter balloon dilatation (inappropriately termed valvuloplasty by the authors—seven patients). Perhaps ironically, the last four of these patients, initially deemed inoperable or high risk, were later submitted to classical aortic valve replacement (AVR), because the surgical risk was considered ‘high but not prohibitive’. Two of them also had severe coronary heart disease and underwent combined myocardial revascularization (CABG). The remaining 27 of the initial 66 patients were primarily sent for