Why the study?
Residual HF symptoms and HF hospitalization remain common after AVR despite improving long-term survival, and are associated with increased mortality and poor health status.
Residual heart failure after aortic valve replacement remains a common and serious issue, prompting research into earlier timing of AVR before extra-valvular cardiac damage occurs.
Residual HF post-TAVR may warrant closer surveillance; leaves open whether earlier AVR prevents extra-valvular damage.
Severe aortic stenosis (AS) carries a poor prognosis with the onset of heart failure (HF) symptoms, and surgical or transcatheter aortic valve replacement (AVR) is its only definitive treatment. The management of AS has seen a paradigm shift with the adoption of transcatheter aortic valve replacement (TAVR), allowing for the treatment of AS in patients who would not otherwise be candidates for surgical AVR. Despite improving long-term survival after TAVR in recent years, residual HF symptoms and HF hospitalization are common and are associated with an increased mortality and a poor health status. This review article summarizes the incidence and risk factors for HF after AVR. Strategies for preventing and better managing HF after AVR are necessary to improve outcomes in this patient population. Extensive research is underway to assess whether earlier timing for AVR, prior to the development of severe symptomatic AS and associated extra-valvular cardiac damage, can improve post-AVR patient outcomes.
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Jakulla et al. (2023) studied this question.
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