Transcatheter aortic valve replacement lacks long-term data in young, low-risk patients (age <75 years), necessitating careful consideration of lifetime management versus surgical replacement.
Careful consideration of lifetime management, including initial intervention and future reinterventions, is required when choosing between TAVR and SAVR for young, low-risk patients with severe aortic stenosis.
Transcatheter aortic valve replacement is now indicated across all risk categories of patients with symptomatic severe aortic stenosis and has been proposed as first line option for the majority of patients >74 years old. However, median age of patients enrolled in the transcatheter aortic valve replacement low-risk trials is 74 years and transcatheter aortic valve replacement has never been systematically investigated in young low risk patients. Although the long-term data in surgical aortic valve replacement in young patients (age <75) are well known, such data remain lacking in transcatheter aortic valve replacement. In the absence of clear guideline recommendations in patients with challenging anatomies (eg, hostile calcium, bicuspid), it is important to know the potential advantages and disadvantages of each treatment and to consider how they might integrate with each other in the lifetime management of such patients. In this review, we discuss current outstanding issues on the management of severe aortic stenosis from a lifetime management perspective, particularly in terms of initial intervention and future reinterventions.
Russo et al. (Tue,) conducted a review in severe aortic stenosis. Transcatheter aortic valve replacement vs. Surgical aortic valve replacement was evaluated. Transcatheter aortic valve replacement lacks long-term data in young, low-risk patients (age <75 years), necessitating careful consideration of lifetime management versus surgical replacement.
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