Why the study?
While patients older than 65 years with aortic stenosis are preferably treated with bioprosthetic tissue valves, there is considerable uncertainty in choosing between TAVR and SAVR.
Individualized decision-making based on patient anatomy and risk is recommended for optimizing the lifelong management of patients with aortic stenosis receiving bioprosthetic valves.
Supports individualized bioprosthetic valve decisions in aortic stenosis; leaves open prospective validation of lifetime risk models.
Aortic stenosis, the most common valvular disease in the Western world, has traditionally been treated with surgical aortic valve replacement (SAVR) but is increasingly treated by transcatheter aortic valve replacement (TAVR). Whereas patients older than 65 years are preferably treated with bioprosthetic tissue valves, there is considerable uncertainty in the choice between TAVR and SAVR. We present various considerations for optimizing the lifelong management of patients receiving bioprosthetic valves (SAVR or TAVR). To maximize life expectancy and to minimize cumulative lifetime risk, we suggest decision-making individualized for patient anatomy and overall (current and future) risk.
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Chen et al. (2024) studied this question.
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