Percutaneous Aortic Valve Replacement - An Alternative to Open Heart Surgery?

The degenerative, calcified aortic stenosis is the most common form of adult valvular heart disease, the prognosis being poor once symptoms (dyspnea at exertion, angina pectoris, syncope) occur. Surgical aortic valve replacement is the method of choice and can be performed at low risk in suitable candidates. However, a fair amount of patients is rejected from surgery due to old age and preexisting comorbidities increasing operative morbidity and mortality. The spectrum of other successful treatment options is limited: Percutaneous aortic balloon valvuloplasty the only interventional treatment option so far does not offer a durable treatment and remains a palliative procedure. Today, with the development of percutaneous aortic valve replacement, the treatment of aortic stenosis has entered a new era providing a new durable treatment option. So far, this method has been restricted to patients at excessive operative risk limiting the number of potential candidates. If subsequent trials are able to confirm the promising initial results, this technique will further expand in clinical application and become an important treatment option for calcified aortic stenosis.