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The Utility of Rapid Atrial Pacing Immediately Post-TAVR to Predict the Need for Pacemaker Implantation Long-Term Durability of Transcatheter Heart Valves: Insights From Bench Testing to 25 Years Increased Risk of Valvular Heart Disease in Systemic Sclerosis: An Underrecognized Cardiac Complication Online Quantitative Aortographic Assessment of Aortic Regurgitation After TAVR: Results of the OVAL Study Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort Comparison of safety and periprocedural complications of transfemoral aortic valve replacement under local anaesthesia: minimalist versus complete Heart Team Coronary Access After TAVR Raising the Evidentiary Bar for Guideline Recommendations for TAVR: JACC Review Topic of the Week Transcatheter Aortic Valve Replacement in Low-risk Patients With Bicuspid Aortic Valve Stenosis Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis
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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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