Transcatheter Aortic Valve Replacement 2016: A Modern-Day "Through the Looking-Glass" Adventure

Transcatheter aortic valve replacement (TAVR) has become a safe and effective therapy for patients with severe aortic stenosis (AS). In recent trials, the hemodynamic performance and clinical outcomes of the latest generation of TAVR devices demonstrated at least parity with surgical outcomes in pat...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2016-03, Vol.67 (12), p.1472-1487
Main Authors: Vahl, Torsten P, Kodali, Susheel K, Leon, Martin B
Format: Article
Language:English
Subjects:
Adventure
Aortic Valve Stenosis - surgery
Cardiology
Catheters
Clinical trials
Heart
Heart Valve Prosthesis
Humans
Medicine
Mortality
Patient Selection
Risk Factors
Studies
Surgery
Transcatheter Aortic Valve Replacement - trends
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Description
Summary:Transcatheter aortic valve replacement (TAVR) has become a safe and effective therapy for patients with severe aortic stenosis (AS). In recent trials, the hemodynamic performance and clinical outcomes of the latest generation of TAVR devices demonstrated at least parity with surgical outcomes in patients of similar risk. Many initial obstacles with TAVR have largely been overcome, including frequent access site complications and concerns about strokes and paravalvular leaks. Using a multidisciplinary heart team approach, patient selection, procedural planning, and device implantation have been refined and optimized such that clinical outcomes are generally predictable and reproducible. Future research will focus on the durability of TAVR devices, further enhancements in clinical outcomes, and adjunctive therapies. On the basis of initial results from ongoing clinical trials, the indication for TAVR will likely expand to lower-risk patients. This review provides an overview of recent progress in this field, and highlights future opportunities and directions.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2015.12.059