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Transcatheter Aortic Valve Replacement

Abstract

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Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients Coronary Access After TAVR Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes Risk of Coronary Obstruction and Feasibility of Coronary Access After Repeat Transcatheter Aortic Valve Replacement With the Self-Expanding Evolut Valve: A Computed Tomography Simulation Study Informed Shared Decisions for Patients with Aortic Stenosis Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Valve Stenosis: 1-Year Results From the All-Comers NOTION Randomized Clinical Trial Transcatheter and surgical aortic valve replacement in patients with bicuspid aortic valve Coronary Protection to Prevent Coronary Obstruction During TAVR: A Multicenter International Registry
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Review ArticleVolume 13, Issue 2 Part 1, February 2020

JOURNAL：JACC Cardiovasc Imaging. Article Link

Management of Asymptomatic Severe Aortic Stenosis: Evolving Concepts in Timing of Valve Replacement

BR Lindman, MR Dweck, P Lancellotti et al. Keywords: aortic stenosis; biomarkers; cardiac magnetic resonance imaging; echocardiography

ABSTRACT

New insights into the pathophysiology and natural history of patients with aortic stenosis, coupled with advances in diagnostic imaging and the dramatic evolution of transcatheter aortic valve replacement, are fueling intense interest in the management of asymptomatic patients with severe aortic stenosis. An intervention that is less invasive than surgery could conceivably justify pre-emptive transcatheter aortic valve replacement in subsets of patients, rather than waiting for the emergence of early symptoms to trigger valve intervention. Clinical experience has shown that symptoms can be challenging to ascertain in many sedentary, deconditioned, and/or elderly patients. Evolving data based on imaging and biomarker evidence of adverse ventricular remodeling, hypertrophy, inflammation, or fibrosis may radically transform existing clinical decision paradigms. Clinical trials currently enrolling asymptomatic patients have the potential to change practice patterns and lower the threshold for intervention.
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