Valvular heart disease 2019

The number of patients suffering from valvular heart diseases is steadily increasing due to the demographic changes and aging of the population. Interventional treatment modalities in particular have gained in importance in recent years. This is especially true for patients with aortic valve stenosis who can benefit from interventional treatment approaches. The number of catheter-based interventions (TAVI) performed in Germany in recent years is higher than the classical surgical aortic valve replacement (SAVR). This is driven not only by convincing results from randomized clinical trials and less invasive approaches but also due to excellent data derived from the mandatory quality assurance. These data could show that the in-hospital mortality was statistically significantly lower for TAVI in comparison to SAVR. The interventional approach has also gained in importance for patients suffering from mitral valve regurgitation secondary to heart failure. The recently presented results of the COAPT trial demonstrated clear superiority of interventional treatment when compared to optimal pharmacotherapy alone. Interventional treatment options for tricuspid valve regurgitation are relatively new. These offer valuable options for many patients for whom a meaningful treatment was so far unavailable, as isolated tricuspid valve surgery is associated with high mortality in this patient group where a high comorbidity is regularly present. This article summarizes the most important new aspects in the field of structural heart diseases

Consensus paper of the German Cardiac Society (DGK) and the German Society for Thoracic and Cardiovascular Surgery (DGTHG) on transcatheter aortic valve implantation (TAVI) 2020

Following the two position papers of the German Cardiac Society (DGK) from 2015 and 2016 on transcatheter aortic valve implantation (TAVI), the DGK and the German Society for Thoracic and Cardiovascular Surgery (DGTHG) have decided to issue a consensus paper on the topic that takes into account the most recent results from randomized controlled trials and registries, with special emphasis on patients with severe aortic stenosis (AS) and low operative risk (STS score 75 years and a suitable anatomy for TAVI. In patients between 70 and 75 years old, a heart team decision between SAVR and TAVI is recommended that considers the patient's life perspective in view of missing long-term data from randomized trials. Taking into account the decision of the Federal Joint Committee (G-BA) on percutaneous heart valve treatment, the personnel and structural prerequisites regarding the qualification of TAVI centers and TAVI surgeons, with the special roles of interventional cardiologists and cardiac surgeons, are defined