During this interactive session two clinical cases of high risk patients with severe aortic stenosis, who were potential candidates for aortic valve implantation were discussed by a group of experts who are surgeons and interventional cardiologists. Each step of the decision-making process was presented and then discussed by the panel. Finally the procedure which was performed was shown and its results described. The speakers gave us several take home messages: a team approach is key for patient selection in this high risk and very heterogenous population. Transcatheter aortic valve implantation can be performed in selected patients and this increases the number of patients who can benefit from an effective treatment. The management of concomitant coronary artery disease is a subject of debate today and must be based on a case by case analysis. Finally, balloon aortic valvuloplasty may be used as a bridge to valve implantation in very high risk patients or when there are temporary uncertainties about the feasibility of valve implantation.
Deciding on percutaneous valve implantation
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