Transcatheter valve replacement often saves patients’ lives. The procedure has become relatively safe and very effective, and may soon become common practice.

Zabiegi przezcewnikowej wymiany zastawek serca często ratują życie pacjentów. Leczenie jest stosunkowo bezpieczne i bardzo skuteczne.

Aortic stenosis is the most common acquired valvular heart disease. Aortic stenosis has growing prevalence in people older than 75 years and natural course of disease is characterized by high mortality rate. According to epidemiological data all patients with aortic stenosis will die after 2–5 years from the first signs of disease if not undergo aortic valve replacement. However, even 40% of patients do not have surgery because of comorbidities related to advanced age. This was the main reason why in 80- and 90-ties of XX century there were intensive attempt to developed an alternative, less invasive treatment methodology for people with aortic stenosis and comorbidities and at high surgical risk. Transcatheter aortic valve implantation (TAVI) was introduced by Dr Alain Cribier in February 2nd, 2002 in Rouen, France. Since that day different aortic transcatheter bioprostheses were used in many randomized clinical trials comparing their safety and effectiveness versus surgical aortic valve replacement. Gradually, it became clear that in all older patients in all risk groups TAVI was equally or even more safe and effective than surgery. Complications after TAVI are relatively rare, but some of them are life-threatening. Heart Team plays a key role in patients selection to TAVI.

Mimo znacznego spadku umieralności choroby układu krążenia nadal są głównym zabójcą Polaków. Istnieją nowe zabiegi, takie jak przezcewnikowe wszczepienie zastawki aortalnej (TAVI), nie są one jednak w wystarczającym stopniu refundowane w porównaniu z krajową skalą problemu oraz średnią europejską. Z tego m.in. powodu Europejskie Towarzystwo Kardiologiczne zainicjowało kampanię Valve for Ufe (,,2astawka to Życie").

This year the new international guidelines of WIST (The World Federation for Interventional Stroke Treatment) on the physician’s training in the interventional acute stroke treatment were published. WIST multispecialty guidelines outline competency and quality standards for physicians and centers to perform safe and effective endovascular stroke treatment with mechanical thrombectomy. The role of quality control and quality assurance is highlighted. WIST establishes an individualized approach to acquiring clinical knowledge and procedural skills to meet the competency requirements for certification of interventionalists of various disciplines and stroke centers in endovascular treatment. WIST guidelines encourage acquisition of skills using innovative training methods such as structured supervised high-fidelity simulation and procedural performance on human perfused cadaveric models. In Poland in 2018 a pilot program on mechanical thrombectomy was established, however endovascular acute stroke treatment is still underused due to limited patients access to stroke centers and too small number of operators.