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Transcatheter Aortic Valve Replacement

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Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients Raising the Evidentiary Bar for Guideline Recommendations for TAVR: JACC Review Topic of the Week Edoxaban versus Vitamin K Antagonist for Atrial Fibrillation after TAVR Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve 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 Long-Term Durability of Transcatheter Heart Valves: Insights From Bench Testing to 25 Years Timing of intervention in asymptomatic patients with valvular heart disease Online Quantitative Aortographic Assessment of Aortic Regurgitation After TAVR: Results of the OVAL Study Temporal Trends in Transcatheter Aortic Valve Replacement in France: FRANCE 2 to FRANCE TAVI A prospective, randomised trial of transapical transcatheter aortic valve implantation vs. surgical aortic valve replacement in operable elderly patients with aortic stenosis: the STACCATO trial
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PerspectiveVolume 74, Issue 18, November 2019

JOURNAL：J Am Coll Cardiol. Article Link

Aortic Valve Stenosis Treatment Disparities in the Underserved JACC Council Perspectives

W Batchelor, S Anwaruddin, L Ross et al. Keywords: aortic stenosis; health care disparities; outcomes; prevalence; TAVR

ABSTRACT

Underserved minorities make up a disproportionately small subset of patients in the United States undergoing transcatheter and surgical aortic valve replacement for aortic stenosis. The reasons for these treatment gaps include differences in disease prevalence and patient, health care system, and disease-related factors. This has major implications not only for minority patients, but also for other groups who face similar challenges in accessing state-of-the-art care for structural heart disease. The authors propose the following key strategies to address these treatment disparities: 1) implementation of measure-based quality improvement programs; 2) effective culturally competent communication and team-based care; 3) improving patient health care access, education, and effective diagnosis; and 4) changing the research paradigm that creates an innovation pipeline for patients. Only a concerted effort from all stakeholders will achieve equitable and broad application of this and other novel structural heart disease treatment modalities in the future.
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