Key result
TAVR is preferred for high-risk severe AS but durability and leak concerns limit lower-risk expansion.
Why the study?
TAVR outcomes have improved but issues like stroke, paravalvular leak, pacemaker need, durability, and reintervention options remain unresolved before expanding use to lower risk patients.
While TAVR is the preferred treatment for high-risk severe aortic stenosis, complications and durability concerns must be resolved before expanding to lower-risk populations.
Confirms TAVR preference in high-risk severe AS; leaves open lower-risk expansion pending durability and leak data.
Transcatheter aortic valve replacement (TAVR) has become the preferred treatment in patients with symptomatic severe aortic stenosis deemed to be at prohibitive or high risk for surgical aortic valve replacement. With evolving technology, improving practices and patient selection, outcomes in TAVR have improved. In the not so distant future, TAVR may become an alternative to surgical aortic valve replacement even for patients who are not at high risk for open surgery. However, issues such as stroke, paravalvular leak and pacemaker need remain, and the unknown limitations of TAVR, including durability and undefined options for reintervention for prosthesis dysfunction, must be addressed before this therapy can be extended to younger, lower risk patients.
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Tang et al. (2014) conducted a review in symptomatic severe aortic stenosis. Transcatheter aortic valve replacement (TAVR) vs. surgical aortic valve replacement was evaluated. Transcatheter aortic valve replacement is a preferred treatment for high-risk severe aortic stenosis, but issues like durability and paravalvular leak must be addressed before expanding to lower-risk patients.
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