BackgroundAortic stenosis is the most common valvular disease in the Western world. It means narrowing of the opening of the aortic valve, that comprises the function of the valve. The disease is characterized by an asymptomatic period, followed by rapidly increasing symptoms and high mortality. Echocardiography is useful in diagnosing aortic stenosis. The only efficient treatment is surgery, and until recently, surgical aortic valve replacement (AVR) was the only surgical option. Transcatheter aortic valve implantation is a new minimal invasive method, in which a bioprosthetic valve is deployed by catheter. MethodWe compared TAVI to AVR in patients over 80 years of age in a retrospective case-control study. The intervention group consisted of the 50 first patients to be operated with TAVI at OUS Rikshospitalet. The control group consisted of 53 patients operated with AVR. They were followed for ≥365 days. ResultsThe two groups were equal preoperatively in terms of median age and hemodynamics but not in terms of logistic EuroSCORE and NYHA class. The postoperative hemodynamics were equal. Mortality was not significantly different between the groups. The incidences of complications were equal between the groups, and comparable to international studies.
ConclusionAVR is a well established treatment of aortic stenosis, and it has good results. Some patients are inoperable by AVR, and TAVI has proved valuable in treating those patients. Further randomized studies are needed to prove efficacy and safety in other patient groups.