Overview
Unverified · drafted by AI from the sources cited below
Definition
Transcatheter aortic valve replacement is an endovascular procedure for the treatment of severe aortic valve stenosis.1 The procedure is used as an alternative option in patients who are deemed at high risk or inoperable for traditional open-heart surgery.1
Diagnosis and risk stratification
The SYNTAX score can be used to quantify the extent of coronary artery disease in patients prior to the procedure.1 In a study analyzing 10,795 patients, 6,150 (57%) had an indication or potential indication for aortic valve replacement, of whom 2,977 (48%) received the intervention.2 The Hemoglobin, Albumin, Lymphocyte, and Platelet score has also been studied to predict outcomes in cohorts such as a study of 395 consecutive patients.3
Treatment
17.4%; p = 0.007).1 Another trial randomly assigned a total of 3000 patients to undergo the procedure with or without cerebral embolic protection.2 Additionally, in a study analyzing 466 matched pairs of patients requiring permanent pacing, cardiac physiological pacing was associated with better long-term clinical outcomes than right ventricular pacing.3
Open questions
Infective endocarditis remains a serious complication, and the role of cardiac surgery in these patients remains uncertain.1 Researchers are also exploring large-scale in silico trials to accelerate device development; one study generated a virtual cohort of 500 synthetic patients and performed nearly 29,000 simulations.2
New research on Transcatheter aortic valve replacement
Journal clubs discussing Transcatheter aortic valve replacement
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Key papers
Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement
New England Journal of Medicine — Kapadia S
329 citations · 2022 · among the most cited on Transcatheter aortic valve replacement
Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients at Low Surgical Risk
Journal of the American College of Cardiology — Leon M
326 citations · 2021 · among the most cited on Transcatheter aortic valve replacement
Evolution and Prognostic Impact of Cardiac Damage After Aortic Valve Replacement
Journal of the American College of Cardiology — Généreux P
176 citations · 2022 · among the most cited on Transcatheter aortic valve replacement
How this page is built
A clinical question appears here only when its condition matches this topic, an outcome and a comparator were extracted from the studies, at least two studies and a patient count are on file, and the certainty is low or higher.
Supports benefit, no benefit shown, and mixed describe the direction of the measured effect. No benefit shown means the evidence does not support a benefit. It is not a finding of harm. Too little evidence means the question did not clear that bar.
Study count, RCT count, and patient count are separate. The patient total adds only studies that are linked into a study family and whose sample size is not flagged as implausible. A reversal is listed only when at least one randomized trial sits on each side of the change.
The overview is drafted from the guideline recommendations, trials, papers, and questions on this page, and every sentence has to cite one of them. It stays unverified until an NPI-verified clinician or a Synapse admin approves it. Approving records that person's name.
