Key result
TAVI improves survival, symptoms, and quality of life over medical therapy in elderly severe AS.
Why the study?
Severe aortic stenosis commonly affects elderly individuals and carries a poor prognosis once symptomatic if untreated, with TAVI now recommended for suitable elderly patients.
Does transcatheter aortic valve implantation (TAVI) improve outcomes compared to SAVR or medical therapy in elderly patients with severe aortic stenosis?
Does transcatheter aortic valve implantation (TAVI) improve outcomes compared to SAVR or medical therapy in elderly patients with severe aortic stenosis?
TAVI is highlighted as the recommended, superior treatment option over SAVR and medical therapy for elderly patients with severe aortic stenosis.
Supports TAVI over medical therapy for survival and symptoms in elderly severe AS; leaves open durability versus SAVR in broader populations.
BACKGROUND: Severe aortic stenosis (AS) is a condition that commonly affects elderly Australians. Once symptomatic, severe AS has a poor prognosis if untreated. Transcatheter aortic valve implantation (TAVI) is a percutaneous procedure that is now the recommended treatment for elderly patients with severe AS who are suitable for intervention. OBJECTIVE: This article provides a contemporary review of the diagnosis and management of severe AS in the elderly. DISCUSSION: Management options for severe AS include TAVI, surgical aortic valve replacement (SAVR), or medical/palliative therapy. In elderly adults, TAVI improves mortality, symptoms and quality of life compared with medical therapy, and is superior to SAVR. The decision regarding which management option is most appropriate for an individual patient is made using a collaborative multidisciplinary approach. General practitioners play key roles in providing information to risk stratify patients when considering intervention, caring for patients after the procedure and/or providing medical and palliative treatment for those deemed unsuitable for intervention.
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Rayner et al. (2023) conducted a review in Severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) vs. Surgical aortic valve replacement (SAVR) or medical therapy was evaluated. Transcatheter aortic valve implantation improves mortality, symptoms, and quality of life compared with medical therapy in elderly patients with severe aortic stenosis.
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