Percutaneous valve replacement and repair in the adult: Techniques and anaesthetic considerations

SummaryStandard treatment for valvular heart diseases such as aortic stenosis and mitral regurgitation includes replacement or repair of the valve. This will require median sternotomy and cardiopulmonary by-pass. In elderly patients with co-morbidity the risks from surgery increase and some patients may be classified as too high risk for surgery.Developments in percutaneous catheter delivered systems make it feasible that non-invasive valve repair and replacement can be performed. Those patients unsuitable for surgical treatment can be offered these procedures. We review the procedures available and the outcome data. We discuss the implications for anaesthesia and intensive care.