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Transcatheter Aortic Valve Replacement: Role of Multimodality Imaging in Common and Complex Clinical Scenarios Single Versus Dual Antiplatelet Therapy Following TAVR: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Anticoagulation with or without Clopidogrel after Transcatheter Aortic-Valve Implantation Randomized Evaluation of TriGuard 3 Cerebral Embolic Protection After Transcatheter Aortic Valve Replacement: REFLECT II Anticoagulation After Surgical or Transcatheter Bioprosthetic Aortic Valve Replacement Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Replacement Impact of myocardial fibrosis on left ventricular remodelling, recovery, and outcome after transcatheter aortic valve implantation in different haemodynamic subtypes of severe aortic stenosis Comparison of 1-Year Pre- And Post-Transcatheter Aortic Valve Replacement Hospitalization Rates: A Population-Based Cohort Study Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes
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Editorial2020 Apr 6;S0828-282X(20)30316-0.

JOURNAL：Can J Cardiol. Article Link

Precision Medicine in TAVR: How to Select the Right Device for the Right Patient

G Marquis-Gravel, S Vemulapalli, AW Asgar et al. Keywords: patient selection; TAVR

ABSTRACT

Transcatheter aortic valve replacement (TAVR) represents a first-line option for the treatment of patients with severe symptomatic aortic stenosis across the entire spectrum of surgical risks. Given the expected growth of TAVR procedures in low-risk patients, many factors other than the primary endpoints of pivotal TAVR trials (either death, or the composite of death or stroke) need to be considered during the selection of a treatment strategy. Such factors include the risk of procedural complications (permanent pacemaker implantation, stroke, new-onset atrial fibrillation, vascular complications, etc), device hemodynamic performance and durability (paravalvular leak [PVL], reinterventions), indication for antithrombotic therapy, and patient quality of life. The pivotal TAVR trials have indicated that some complications with TAVR vs surgical aortic valve replacement (SAVR) vary according to the device under study. For example, rates of permanent pacemaker implantation were higher with TAVR vs SAVR in trials evaluating self-expanding valves, but not in the those evaluating balloon-expandable valves. TAVR represents a suitable option for all risk groups, but how do we personalise care and select the most appropriate device for our patients?
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