Transcatheter aortic valve replacement: potential use in lower-risk aortic stenosis.

Transcatheter aortic valve replacement: potential use in lower-risk aortic stenosis. Expert Rev Cardiovasc Ther. 2020 Oct 06;: Authors: Laricchia A, Khokhar AA, Gallo F, Giannini F, Colombo A, Latib A, Mangieri A Abstract INTRODUCTION: The widespread use of transcatheter aortic valve implantation (TAVI) is expanding to low-risk patients. Nevertheless, a low clinical risk does not always correspond to a low procedural risk for the percutaneous approach. AREAS COVERED: The initial trials on TAVI in low-risk populations had encouraging results, showing non-inferiority in comparison to surgical aortic valve replacement (SAVR). However, the low-risk definition is based on risk score calculators developed for the surgical setting and not including other specific features that are more relevant to TAVI and can affect procedural outcomes. For example, the presence of bicuspid aortic valves, high calcific burden, low coronary height or conduction disturbances are all potentially associated with suboptimal results or even procedural complications. In addition, the lack of longer follow-up prevents us to draw conclusions about long-term outcomes, including data about valve durability and coronary re-access. EXPERT OPINION: Although current evidences suggest similar results for TAVI and SAVR in low-risk populations, there are some technical and procedural limitations that still need to be addressed in order to close the gap betwe...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research