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Qualitätskriterien zur Durchführung der kathetergestützten Aortenklappenimplantation (TAVI)

Aktualisierung des Positionspapiers der Deutschen Gesellschaft für Kardiologie

Quality criteria for the implementation of transcatheter aortic valve implantation

Update of the position paper of the German Cardiac Society

  • Positionspapier
  • Published:
Der Kardiologe Aims and scope

Zusammenfassung

Neuere Studien- und Registerdaten zur kathetergestützten Aortenklappenimplantation (TAVI) haben eine Aktualisierung des 2015 veröffentlichten Positionspapiers der Deutschen Gesellschaft für Kardiologie (DGK) zu diesem Behandlungsverfahren notwendig gemacht. Vorgestellt werden die Ergebnisse von randomisierten Studien, in denen TAVI und chirurgischer Aortenklappenersatz bei Patienten mit mittlerem und niedrigem operativen Risiko verglichen werden, Daten zum Langzeitverlauf der ersten randomisierten Hochrisikopatienten sowie Analysen großer Populationsregister aus Deutschland und den USA. Daraus resultieren aktualisierte Indikationsstellungen für eine TAVI bei Patienten ≥85 Jahre, Patienten, die nach dem STS-Score oder dem logistischen EuroSCORE ein niedriges, mittleres oder hohes OP-Risiko haben, sowie bei Patienten mit vorbestehender Herz-OP oder eingeschränkter Gesamtprognose. Dieses Dokument ergänzt das Positionspapier der DGK von 2015.

Abstract

Recent scientific evidence on transcatheter aortic valve implantation (TAVI) has necessitated an update of the 2015 position paper of the German Cardiac Society (GCS) on this treatment modality. We present findings from randomised trials comparing TAVI and surgical aortic valve replacement in patients with intermediate and low operative risk, data on the long-term outcome of the first high-risk patients enrolled in randomised trials, and analyses of large population-based registries from Germany and the USA. They have resulted in updated indications for TAVI in patients ≥85 years, patients at low, intermediate, or high surgical risk according to the STS score or the logistic EuroSCORE, as well as patients with a history of cardiac surgery or patients with an impaired overall prognosis. This document complements the 2015 position paper of the GCS.

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Author information

Authors and Affiliations

  1. Abteilung für Kardiologie, Herz-, Gefäß-, Diabeteszentrum, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland

    K.-H. Kuck

  2. Medizinisches Versorgungszentrum, Cardioangiologisches Centrum Bethanien, Frankfurt, Deutschland

    H. Eggebrecht

  3. Herzzentrum, Klinik für Kardiologie, Klinikum Oldenburg GmbH, Oldenburg, Deutschland

    A. Elsässer

  4. Medizinische Klinik I – Kardiologie und Angiologie, Universitätsklinikum Gießen und Marburg, Gießen, Deutschland

    C. Hamm

  5. Medizinische Klinik I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Deutschland

    M. Haude

  6. Abteilung Kardiologie, Universitätsmedizin Rostock, Klinik für Innere Medizin – Kardiologie und konserv. Intensivmedizin, Vivantes Klinikum im Friedrichshain und Vivantes Klinikum am Urban, Berlin, Deutschland

    H. Ince

  7. Klinik für Kardiologie, Angiologie und Pneumologie, Medizinische Universitätsklinik Heidelberg, Heidelberg, Deutschland

    H. Katus

  8. Klinik für Innere Medizin, St. Johannes Hospital, Dortmund, Deutschland

    H. Möllmann

  9. Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Deutschland

    C. K. Naber

  10. Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, München, Deutschland

    H. Schunkert

  11. Medizinische Klinik II (Kardiologie, Angiologie, Intensivmedizin), Universitäres Herzzentrum Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland

    H. Thiele

  12. Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Deutschland

    N. Werner

Authors
  1. K.-H. Kuck
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  2. H. Eggebrecht
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  3. A. Elsässer
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  4. C. Hamm
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  5. M. Haude
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  6. H. Ince
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  7. H. Katus
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  8. H. Möllmann
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  9. C. K. Naber
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  10. H. Schunkert
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  11. H. Thiele
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  12. N. Werner
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Correspondence to K.-H. Kuck.

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Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Kuck, KH., Eggebrecht, H., Elsässer, A. et al. Qualitätskriterien zur Durchführung der kathetergestützten Aortenklappenimplantation (TAVI). Kardiologe 10, 282–300 (2016). https://doi.org/10.1007/s12181-016-0082-4

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