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Eur J Cardiothorac Surg 2007;31:1-3. doi:10.1016/j.ejcts.2006.10.001
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Editorials

Off-pump aortic valve replacement with catheter-mounted valved stents.

Is the future already here?

Cardiothoracic Surgery, University Hospital, 3000 Coimbra Codex, Coimbra, Portugal

^_* Corresponding author. Tel.: +351 39 400418; fax: +351 39 829674. (Email: antunes.cct.huc@sapo.pt).

The first 300 words of the full text of this article appear below.

Since the introduction of the first valve prosthesis in the early 60's, aortic valve replacement (AVR) has contributed to better, and in many cases to save, the lives of hundreds of thousands of patients. From the early Starr ball-valve (not to mention the precocious Hufnagel valve), several types of prostheses, both mechanical and biological, were developed and recent models have reached high-level performances, which succeed in returning patients to good quality of life and to survivals that match those of the normal population. Today, aortic valve replacement is the most common valve operation and one of the most common open heart procedures, after CABG, performed throughout the world. In most cases, the procedure is performed to treat aortic stenosis, which affects between 2% and 5% of elderly individuals in most developed countries.

Currently, on-pump aortic valve replacement is carried out with very low mortality and acceptable morbidity in the vast majority of patients and only exceptionally it is denied to patients considered to be too high-risk because of the presence of significant co-morbidity. Hence, this procedure remains as the golden standard for the treatment of aortic valve stenosis and/or regurgitation. Nonetheless, it may be conceded that there are a few patients who may constitute unacceptably high risk for open heart procedures. Hence, efforts to treat aortic stenosis by less invasive, lower risk methods have been made in the last decade. Following a relatively successful utilization in neonatal aortic stenosis, balloon commissurotomy was attempted in patients with calcific aortic stenosis (AS), especially in the elderly, mostly with deceptive results and the procedure was almost abandoned. Results from several individual centres and the multicentre NHLBI registry showed only a modest early clinical improvement, a substantial incidence of peripheral vascular complications, a 30-day mortality of up to 10%, and a high incidence of . . . [Full Text of this Article]

This article has been cited by other articles:

				M. J. Antunes Percutaneous aortic valve implantation. The demise of classical aortic valve replacement? Eur. Heart J., June 1, 2008; 29(11): 1339 - 1341. [Full Text] [PDF]

				R. Quaden, T. Attmann, M. Schunke, D. Theisen-Kunde, J. Cremer, and G. Lutter Percutaneous aortic valve replacement: Endovascular resection of human aortic valves in situ. J. Thorac. Cardiovasc. Surg., May 1, 2008; 135(5): 1081 - 1086. [Abstract] [Full Text] [PDF]