
Henry Smith
83, Male
The European Society of Cardiology (among others) publish guidelines on the management of patients with severe symptomatic aortic stenosis, like Mr Smith (Fig 9).
The choice here is essentially between surgical aortic valve replacement (‘SAVR’) and transcatheter aortic valve intervention (‘TAVI’, Fig 10 and associated video).
Management of severe aortic stenosis
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Fig 9. Indications for intervention in aortic stenosis and recommendations for the choice of intervention
Source: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Valvular-Heart-Disease-Management-of -
Fig 10. Schematic representation of TAVI.
A balloon is positioned across the aortic valve and gently inflated (A). A tissue valve inside a crimped metal stent is placed in position (B). The new valve either expands by itself or is expanded using a balloon (C). The balloon and catheter are removed, leaving a new valve inside the stenoised valve.