Key result
Management of symptomatic severe aortic stenosis remains primarily surgical, though transcatheter aortic valve replacement is an accepted alternative for patients at high or prohibitive operative risk.
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This review highlights that while symptomatic aortic stenosis is primarily managed surgically, TAVR is an accepted alternative for high-risk patients.
Valvular aortic stenosis (AS) is a progressive disease that affects 2% of the population aged 65 years or older. The major cause of valvular AS in adults is calcification and fibrosis of a previously normal tricuspid valve or a congenital bicuspid valve, with rheumatic AS being rare in the United States. Once established, the rate of progression of valvular AS is quite variable and impossible to predict for any particular patient. Symptoms of AS are generally insidious at onset, though development of any of the three cardinal symptoms of angina, syncope, or heart failure portends a poor prognosis. Management of symptomatic AS remains primarily surgical, though transcatheter aortic valve replacement (TAVR) is becoming an accepted alternative to surgical aortic valve replacement (SAVR) for patients at high or prohibitive operative risk.
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Czarny et al. (2014) conducted a review in Valvular Aortic Stenosis. Surgical and transcatheter aortic valve replacement vs. Medical therapy was evaluated. Management of symptomatic severe aortic stenosis remains primarily surgical, though transcatheter aortic valve replacement is an accepted alternative for patients at high or prohibitive operative risk.
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