TAVR - From inoperable to younger, lower-risk patients: A slippery slope?

Prog Cardiovasc Dis. 2022 May-Jun:72:41-53. doi: 10.1016/j.pcad.2022.04.001. Epub 2022 Apr 6.

Abstract

Despite current valve guidelines recommending both transcatheter and surgical aortic valve replacement (TAVR and SAVR, respectively) in patients with symptomatic severe aortic stenosis (AS), TAVR has recently become the preferred treatment over SAVR, driven by its minimal invasiveness, faster recovery and earlier improvement in quality of life. However, several limitations and unresolved issues remain with TAVR, including stroke, conduction system disorder, durability, bicuspid anatomy, coronary reaccess and lifetime management with aortic valve reintervention. Our review aims to highlight the above issues and discuss them in depth, to demonstrate the complementary role of TAVR and SAVR in the treatment of AS.

Keywords: Aortic valve stenosis; Bicuspid aortic valve stenosis; Surgical aortic valve replacement; Transcatheter aortic valve implantation; Transcatheter aortic valve replacement.

Publication types

  • Review

MeSH terms

  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / diagnostic imaging
  • Aortic Valve Stenosis* / surgery
  • Heart Valve Prosthesis Implantation*
  • Heart Valve Prosthesis*
  • Humans
  • Quality of Life
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • Treatment Outcome