Aortenklappenersatz bei älteren Patienten mit Schwerer Aortenstenose

Severe calcific aortic stenosis is a disease of the elderly and associated with reduced quality of life and adverse prognosis. According to demographic estimations the share of octogenarians will markedly increase in the course of the decades to come. As a consequence, the incidence of symptomatic aortic stenosis will increase along with the need for minimally invasive treatment options. Since to date there is no efficacious medical treatment for aortic stenosis, elderly patients suffering from significant co-morbidities that portend an increased risk for surgery may benefit from a novel intervention with a minimally-invasive approach. Until this moment, seven years after the first successful transcatheter aortic valve implantation, transfemoral or transapical aortic valves have been implanted worldwide in approximately 10 000 patients. Clinical trials and early experience indicate that this minimally invasive intervention proves successful in >90%. Thirty-day mortality amounts to 10% and in case of a successful procedure a significant reduction of symptoms and an improvement of quality of life can be expected. Vascular access site complications and atrio-ventricular conduction disturbances are the most commonly observed adverse events.