Interdisciplinary consensus on indications for transfemoral transcatheter aortic valve implantation (TF-TAVI)
Indications for TF-TAVI (transfemoral transcatheter aortic valve implantation) are rapidly changing according to increasing evidence from randomized controlled trials. Present trials document the non-inferiority or even superiority of TF-TAVI in intermediate-risk patients (STS-Score 4–8%) as well as...
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| creator | von Scheidt Wolfgang Welz, A Pauschinger, M Fischlein, T Schächinger, V Treede, H Zahn, R Hennersdorf, M Albes, J M Bekeredjian, R Beyer, M Brachmann, J Butter, C Bruch, L Dörge, H Eichinger, W Franke U F W Friedel, N Giesler, T Gradaus, R Hambrecht, R Haude, M Hausmann, H Heintzen, M P Jung, W Kerber, S Mudra, H Nordt, T Pizzulli, L F-U, Sack Sack, S Schumacher, B Schymik, G Sechtem, U Stellbrink, C Stumpf, C Hoffmeister, H M |
| description | Indications for TF-TAVI (transfemoral transcatheter aortic valve implantation) are rapidly changing according to increasing evidence from randomized controlled trials. Present trials document the non-inferiority or even superiority of TF-TAVI in intermediate-risk patients (STS-Score 4–8%) as well as in low-risk patients (STS-Score |
| doi_str_mv | 10.1007/s00392-019-01528-5 |
| format | Article |
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Present trials document the non-inferiority or even superiority of TF-TAVI in intermediate-risk patients (STS-Score 4–8%) as well as in low-risk patients (STS-Score < 4%). However, risk scores exhibit limitations and, as a single criterion, are unable to establish an appropriate indication of TF-TAVI vs transapical TAVI vs SAVR (surgical aortic valve replacement). The ESC (European Society of Cardiology)/EACTS (European Association for Cardio-Thoracic Surgery) guidelines 2017 and the German DGK (Deutsche Gesellschaft für Kardiologie)/DGTHG (Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie) commentary 2018 offer a framework for the selection of the best therapeutic method, but the individual decision is left to the discretion of the heart teams. An interdisciplinary TAVI consensus group of interventional cardiologists of the ALKK (Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte e.V.) and cardiac surgeons has developed a detailed consensus on the indications for TF-TAVI to provide an up-to-date, evidence-based, comprehensive decision matrix for daily practice. The matrix of indication criteria includes age, risk scores, contraindications against SAVR (e.g., porcelain aorta), cardiovascular criteria pro TAVI, additional criteria pro TAVI (e.g., frailty, comorbidities, organ dysfunction), contraindications against TAVI (e.g., endocarditis) and cardiovascular criteria pro SAVR (e.g., bicuspid valve anatomy). This interdisciplinary consensus may provide orientation to heart teams for individual TAVI-indication decisions. Future adaptations according to evolving medical evidence are to be expected.Graphic abstractInterdisciplinary consensus on indications for transfemoral transcatheter aortic valve implantation (TF-TAVI).</description><identifier>ISSN: 1861-0684</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-019-01528-5</identifier><language>eng</language><publisher>Heidelberg: Springer Nature B.V</publisher><subject>Adaptation ; Aorta ; Aortic valve ; Cardiology ; Clinical trials ; Criteria ; Endocarditis ; Heart ; Implantation ; Indication ; Interdisciplinary aspects ; Medical personnel ; Patients ; Porcelain ; Risk ; Surgeons ; Surgery ; Thoracic surgery ; Thorax</subject><ispartof>Clinical research in cardiology, 2020-01, Vol.109 (1), p.1-12</ispartof><rights>Clinical Research in Cardiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c775-2a0768b5db35618f2dd120cf27b11224d3758867bc0d11d19d0e1fcc125ba5f53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>von Scheidt Wolfgang</creatorcontrib><creatorcontrib>Welz, A</creatorcontrib><creatorcontrib>Pauschinger, M</creatorcontrib><creatorcontrib>Fischlein, T</creatorcontrib><creatorcontrib>Schächinger, V</creatorcontrib><creatorcontrib>Treede, H</creatorcontrib><creatorcontrib>Zahn, R</creatorcontrib><creatorcontrib>Hennersdorf, M</creatorcontrib><creatorcontrib>Albes, J M</creatorcontrib><creatorcontrib>Bekeredjian, R</creatorcontrib><creatorcontrib>Beyer, M</creatorcontrib><creatorcontrib>Brachmann, J</creatorcontrib><creatorcontrib>Butter, C</creatorcontrib><creatorcontrib>Bruch, L</creatorcontrib><creatorcontrib>Dörge, H</creatorcontrib><creatorcontrib>Eichinger, W</creatorcontrib><creatorcontrib>Franke U F W</creatorcontrib><creatorcontrib>Friedel, N</creatorcontrib><creatorcontrib>Giesler, T</creatorcontrib><creatorcontrib>Gradaus, R</creatorcontrib><creatorcontrib>Hambrecht, R</creatorcontrib><creatorcontrib>Haude, M</creatorcontrib><creatorcontrib>Hausmann, H</creatorcontrib><creatorcontrib>Heintzen, M P</creatorcontrib><creatorcontrib>Jung, W</creatorcontrib><creatorcontrib>Kerber, S</creatorcontrib><creatorcontrib>Mudra, H</creatorcontrib><creatorcontrib>Nordt, T</creatorcontrib><creatorcontrib>Pizzulli, L</creatorcontrib><creatorcontrib>F-U, Sack</creatorcontrib><creatorcontrib>Sack, S</creatorcontrib><creatorcontrib>Schumacher, B</creatorcontrib><creatorcontrib>Schymik, G</creatorcontrib><creatorcontrib>Sechtem, U</creatorcontrib><creatorcontrib>Stellbrink, C</creatorcontrib><creatorcontrib>Stumpf, C</creatorcontrib><creatorcontrib>Hoffmeister, H M</creatorcontrib><title>Interdisciplinary consensus on indications for transfemoral transcatheter aortic valve implantation (TF-TAVI)</title><title>Clinical research in cardiology</title><description>Indications for TF-TAVI (transfemoral transcatheter aortic valve implantation) are rapidly changing according to increasing evidence from randomized controlled trials. Present trials document the non-inferiority or even superiority of TF-TAVI in intermediate-risk patients (STS-Score 4–8%) as well as in low-risk patients (STS-Score < 4%). However, risk scores exhibit limitations and, as a single criterion, are unable to establish an appropriate indication of TF-TAVI vs transapical TAVI vs SAVR (surgical aortic valve replacement). The ESC (European Society of Cardiology)/EACTS (European Association for Cardio-Thoracic Surgery) guidelines 2017 and the German DGK (Deutsche Gesellschaft für Kardiologie)/DGTHG (Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie) commentary 2018 offer a framework for the selection of the best therapeutic method, but the individual decision is left to the discretion of the heart teams. An interdisciplinary TAVI consensus group of interventional cardiologists of the ALKK (Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte e.V.) and cardiac surgeons has developed a detailed consensus on the indications for TF-TAVI to provide an up-to-date, evidence-based, comprehensive decision matrix for daily practice. The matrix of indication criteria includes age, risk scores, contraindications against SAVR (e.g., porcelain aorta), cardiovascular criteria pro TAVI, additional criteria pro TAVI (e.g., frailty, comorbidities, organ dysfunction), contraindications against TAVI (e.g., endocarditis) and cardiovascular criteria pro SAVR (e.g., bicuspid valve anatomy). This interdisciplinary consensus may provide orientation to heart teams for individual TAVI-indication decisions. Future adaptations according to evolving medical evidence are to be expected.Graphic abstractInterdisciplinary consensus on indications for transfemoral transcatheter aortic valve implantation (TF-TAVI).</description><subject>Adaptation</subject><subject>Aorta</subject><subject>Aortic valve</subject><subject>Cardiology</subject><subject>Clinical trials</subject><subject>Criteria</subject><subject>Endocarditis</subject><subject>Heart</subject><subject>Implantation</subject><subject>Indication</subject><subject>Interdisciplinary aspects</subject><subject>Medical personnel</subject><subject>Patients</subject><subject>Porcelain</subject><subject>Risk</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Thoracic 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; Jung, W ; Kerber, S ; Mudra, H ; Nordt, T ; Pizzulli, L ; F-U, Sack ; Sack, S ; Schumacher, B ; Schymik, G ; Sechtem, U ; Stellbrink, C ; Stumpf, C ; Hoffmeister, H M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c775-2a0768b5db35618f2dd120cf27b11224d3758867bc0d11d19d0e1fcc125ba5f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adaptation</topic><topic>Aorta</topic><topic>Aortic valve</topic><topic>Cardiology</topic><topic>Clinical trials</topic><topic>Criteria</topic><topic>Endocarditis</topic><topic>Heart</topic><topic>Implantation</topic><topic>Indication</topic><topic>Interdisciplinary aspects</topic><topic>Medical personnel</topic><topic>Patients</topic><topic>Porcelain</topic><topic>Risk</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Thoracic 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Sack</au><au>Sack, S</au><au>Schumacher, B</au><au>Schymik, G</au><au>Sechtem, U</au><au>Stellbrink, C</au><au>Stumpf, C</au><au>Hoffmeister, H M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interdisciplinary consensus on indications for transfemoral transcatheter aortic valve implantation (TF-TAVI)</atitle><jtitle>Clinical research in cardiology</jtitle><date>2020-01-01</date><risdate>2020</risdate><volume>109</volume><issue>1</issue><spage>1</spage><epage>12</epage><pages>1-12</pages><issn>1861-0684</issn><eissn>1861-0692</eissn><abstract>Indications for TF-TAVI (transfemoral transcatheter aortic valve implantation) are rapidly changing according to increasing evidence from randomized controlled trials. Present trials document the non-inferiority or even superiority of TF-TAVI in intermediate-risk patients (STS-Score 4–8%) as well as in low-risk patients (STS-Score < 4%). However, risk scores exhibit limitations and, as a single criterion, are unable to establish an appropriate indication of TF-TAVI vs transapical TAVI vs SAVR (surgical aortic valve replacement). The ESC (European Society of Cardiology)/EACTS (European Association for Cardio-Thoracic Surgery) guidelines 2017 and the German DGK (Deutsche Gesellschaft für Kardiologie)/DGTHG (Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie) commentary 2018 offer a framework for the selection of the best therapeutic method, but the individual decision is left to the discretion of the heart teams. An interdisciplinary TAVI consensus group of interventional cardiologists of the ALKK (Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte e.V.) and cardiac surgeons has developed a detailed consensus on the indications for TF-TAVI to provide an up-to-date, evidence-based, comprehensive decision matrix for daily practice. The matrix of indication criteria includes age, risk scores, contraindications against SAVR (e.g., porcelain aorta), cardiovascular criteria pro TAVI, additional criteria pro TAVI (e.g., frailty, comorbidities, organ dysfunction), contraindications against TAVI (e.g., endocarditis) and cardiovascular criteria pro SAVR (e.g., bicuspid valve anatomy). This interdisciplinary consensus may provide orientation to heart teams for individual TAVI-indication decisions. Future adaptations according to evolving medical evidence are to be expected.Graphic abstractInterdisciplinary consensus on indications for transfemoral transcatheter aortic valve implantation (TF-TAVI).</abstract><cop>Heidelberg</cop><pub>Springer Nature B.V</pub><doi>10.1007/s00392-019-01528-5</doi><tpages>12</tpages></addata></record> |
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| issn | 1861-0684 1861-0692 |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Adaptation Aorta Aortic valve Cardiology Clinical trials Criteria Endocarditis Heart Implantation Indication Interdisciplinary aspects Medical personnel Patients Porcelain Risk Surgeons Surgery Thoracic surgery Thorax |
| title | Interdisciplinary consensus on indications for transfemoral transcatheter aortic valve implantation (TF-TAVI) |
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