[Transcheter aortic valve implantation as a method of treatment of chronic heart failure in elderly and old patients: Literature review (part 2).]

The most common heart valve defect among the elderly and senile is aortic valve stenosis. The traditional method of treating severe aortic valve stenosis is open surgery to replace aortic valve. At the same time, a more modern, minimally invasive method of correcting aortic stenosis is transcatheter aortic valve implantation (TAVI). This intervention is primarily indicated for patients of old age suffering from severe chronic heart failure associated with aortic stenosis, who have a high surgical risk. Currently, TAVI has evolved from a complex and dangerous procedure into an effective and safe method of treatment thanks to the development of a new generation of devices. Currently, there are still topical issues of using TAVI in individual clinical cases (use of TAVI in the elderly (60-75 years), TAVI in centenarians (90 years or more), TAVI in frailty, the feasibility of performing TAVI with low surgical risk, etc.), as well as issues related to longevity valves used for TAVI and prognosis in terms of quality and life expectancy.

[Transcheter aortic valve implantation as a method of treatment of chronic heart failure in elderly and old patients: Literature review (part 1).]

Aortic valve (AV) stenosis is the most common acquired valvular disease with an increasing prevalence due to an aging population, requiring surgical or endovascular intervention. Transcatheter Aortic Valve Implantation (TAVI) represents a real revolution in the field of interventional cardiology for the treatment of elderly or high-risk patients with severe symptomatic AV stenosis. TAVI allows for the correction of aortic defect in the most severe group of patients with chronic heart failure (CHF) with severe comorbidity, who are contraindicated for open surgery to replace AV, in order to interrupt the vicious circle in the progression of CHF, stimulate reverse myocardial remodeling, alleviate symptoms, improve the quality of life, and prognosis of patients, and also as a «bridge¼ to heart transplantation. With the development of next-generation devices, TAVI has evolved from a complex and dangerous procedure to an effective and safe technique. Currently, the greatest scientific interest is the study of valve durability and the possibility of expanding the indications for performing TAVI in categories of patients with low surgical risk, as well as in younger age groups.