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Transcatheter Aortic Valve Replacement

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Determinants and Impact of Heart Failure Readmission Following Transcatheter Aortic Valve Replacement Long-term outcome of prosthesis-patient mismatch after transcatheter aortic valve replacement The Utility of Rapid Atrial Pacing Immediately Post-TAVR to Predict the Need for Pacemaker Implantation Randomized Evaluation of TriGuard 3 Cerebral Embolic Protection After Transcatheter Aortic Valve Replacement: REFLECT II Prognostic Value of Computed Tomography-Derived Extracellular Volume in TAVR Patients With Low-Flow Low-Gradient Aortic Stenosis Safety and efficacy of a self-expanding versus a balloon-expandable bioprosthesis for transcatheter aortic valve replacement in patients with symptomatic severe aortic stenosis: a randomised non-inferiority trial Precision Medicine in TAVR: How to Select the Right Device for the Right Patient Why and How to Measure Aortic Valve Calcification in Patients With Aortic Stenosis Anticoagulation After Surgical or Transcatheter Bioprosthetic Aortic Valve Replacement Left Ventricular Hypertrophy and Clinical Outcomes Over 5 Years After TAVR: An Analysis of the PARTNER Trials and Registries
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GuidelineJuly 21, 2021

JOURNAL：JAMA Cardiol. Article Link

Guideline Update on Indications for Transcatheter Aortic Valve Implantation Based on the 2020 American College of Cardiology/American Heart Association Guidelines for Management of Valvular Heart Disease

TM Sundt; H Jneid et al. Keywords: TAVR; valular heart disease; indication; guideline

ABSTRACT

The continued evolution of transcatheter aortic valve implantation (TAVI) technology and the results of multiple randomized clinical trials (RCTs) have firmly established this approach as an alternative to surgical aortic valve replacement (SAVR) in the treatment of aortic stenosis in all risk groups. Deciding on TAVI or SAVR depends on patient-specific factors, including technical, procedure-specific contraindications and the balance between estimated life expectancy and anticipated prosthesis durability. These factors pertain to the decision between mechanical and biological prostheses, and if the choice is biological, between SAVR and TAVI. A strong emphasis is now placed on shared decision-making with the patient and involvement of the multidisciplinary heart team. For most patients younger than 65 years, SAVR is recommended, with mechanical valves favored in those younger than 50 years. For those older than 65 years, the perioperative risks of mortality and stroke are lower with transfemoral TAVI compared with SAVR, but the risks of paravalvular leak, a pacemaker requirement, and vascular complications are higher.
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