The implications and requirements of transcatheter aortic valve replacement in low-risk patients

Özet

Transcatheter aortic valve replacement (TAVR) is a transformative technology that has changed the management of patients with severe, symptomatic aortic stenosis. The use of TAVR in intermediate- to high-risk patients has been validated in several rigorously performed, randomizedclinical trials. Recent studies using newer generation devices have demonstrated the noninferiority of TAVR as compared with surgical aorticvalve replacement in low-risk patients, supporting the increased utilization and expansion of TAVR. The use of TAVR in low-risk patients hasimportant implications and requires a multifaceted approach that includes a highly functional multidisciplinary heart team for careful patientselection; a need to understand and help mitigate certain key complications, such as stroke, paravalvular regurgitation, and conduction disturbances; careful data collection for continual outcome assessment and improvement; and the necessary expertize and procedural volume tomaintain excellent outcomes and ensure optimal clinical care pathways. (Anatol J Cardiol 2020; 23: 2-9)