Treatment of high-risk patients with severe aortic stenosis by the use of transcatheter aortic valve implantation

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Abstract

Aortic stenosis is the most common disease from the group of acquired heart diseases. The frequency and degree of damage of the aortic valve increases with age. The prevalence of this disease increases due to the general extension in life expectancy of the population. Aortic valve stenosis caused by calcification is the pathology with progressive course characterized by a poor prognosis at the stage of expanded symptoms. Five-year survival of patients with developed clinical picture of aortic stenosis without surgery, according to some estimates, is reduced to 15%, which is the worst figure, even in comparison with most potentially incurable cancer. In the treatment of aortic stenosis aortic valve replacement is the “gold standard” and gives positive results in all age groups of patients. Only one third of patients are sent for aortic valve replacement owing to high risk caused by the age, severity of the defect, reduced contractility of the left ventricle, pulmonary hypertension and other comorbidities. Aortic valve replacement in patients of the older age groups with concomitant diseases is associated with high level of hospital mortality. One of the attempts to reduce the frequency of complications and mortality in this group of patients is the implementation of a less traumatic surgery – transcatheter aortic valve implantation. At present our clinic has successfully performed more than 70 operations of transcatheter aortic valve implantation. Transcatheter aortic valve implantation is a good alternative to standard aortic valve replacement in patients with high risk of open-heart surgery.

About the authors

Alexey V. Sizov

St. Petersburg State Pediatric Medical University

Author for correspondence.
Email: avsizov.spb@mail.ru

MD, PhD, Associate Professor, Department of Faculty Therapy named after professor V.A. Valdman

Russian Federation, Saint Petersburg

Alexey S. Sergeev

St. Petersburg State City Hospital No 2

Email: 3125155@gmail.com

Surgeon, Department of Endovascular Methods of Diagnosis and Treatment

Russian Federation, Saint Petersburg

Evgeny A. Shloydo

St. Petersburg State City Hospital No 2

Email: 3125155@gmail.com

MD, PhD, Chief, Department of Endovascular Methods of Diagnosis and Treatment

Russian Federation, Saint Petersburg

Valentin K. Suchov

St. Petersburg State City Hospital No 2

Email: 3125155@gmail.com

MD, PhD, Dr Med Sci, Professor, Department of Endovascular Methods of Diagnosis and Treatment

Russian Federation, Saint Petersburg

Victoria V. Zvereva

St. Petersburg State City Hospital No 2

Email: vvzvereva@mail.ru

Cardiologist, Department of Cardiology No 1

Russian Federation, Saint Petersburg

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Copyright (c) 2018 Sizov A.V., Sergeev A.S., Shloydo E.A., Suchov V.K., Zvereva V.V.

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