Key result
TAVR proves viable for low-risk AS but requires careful lifetime management of durability and reintervention.
Why the study?
TAVR is now the preferred therapy across risk levels, necessitating a review of the evidence supporting its use, clinical guidelines, and ongoing challenges in low-risk and younger patients with AS.
This review emphasizes the critical shift toward lifetime management in aortic stenosis, highlighting the importance of considering valve durability, coronary access, and future reinterventions when choosing between TAVR and SAVR in younger, low-risk patients.
Highlights need for lifetime planning in low-risk aortic stenosis; leaves open optimal durability and reintervention strategies.
Aortic stenosis (AS) is the most prevalent forms of valvular heart disease (VA), affecting millions of patients on an annual basis. It carries significant risk for morbidity and mortality if left untreated. (1) Currently, no pharmaceutical therapy with proven effect in slowing the progression of AS exists. Thus, effective therapy relies upon timely diagnosis, surveillance in the early stages, and prompt treatment when indicated. (2) Transcatheter aortic valve replacement (TAVR) has changed the landscape for treatment of AS, resulting in greater awareness and diagnosis of the disease, and prompting calls for earlier therapy. In addition, while TAVR was initially approved in high-risk symptomatic patients with severe AS or those with prohibitive risk who were poor candidates for surgery, it is now the preferred therapy for all risk levels and for most patients with AS. (3) In this review, we aim to highlight the evidence supporting TAVR in low-risk patients, guidelines for clinical use, and continuing challenges for treatment of AS patients at both lower risk and younger ages.
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Moumneh et al. (2024) conducted a review in Aortic stenosis. Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated. Transcatheter aortic valve replacement is a viable treatment for low-risk patients with aortic stenosis, requiring careful consideration of lifetime management factors like durability and reintervention.
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