Aortic stenosis – TAVR (TAVI) vs SAVR

Discussion so far is based on ACC/AHA guidelines, 2020 [1]. ESC/EACTS guidelines for management of valvular heart disease were published in 2017 [2]. The guideline mentions that data on TAVI are limited for patients below 75 years and for low surgical risk patients. Hence SAVR was preferred in those patients. On this aspect, the more recent ACC/AHA guidelines incorporate more recent evidence. In ESC/EACTS guidelines, SAVR is preferred if STS/EuroSCORE II is less than 4% and TAVI if it is more than or equal to 4%. TAVI is preferred in those with severe comorbidity, previous cardiac surgery, frailty, and restricted mobility. SAVR is preferred if there is a suspicion of endocarditis. References Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP 3rd, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, O’Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A, Toly C. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Feb 2;143(5):e72-e227.  Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Muñoz D, Rosenhek R, Sjögren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017 Sep 21;38(36):2739-2791. The post Aorti...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Angiography and Interventions Cardiac Surgery Structural Heart Disease Interventions Source Type: blogs