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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Outcomes of surgical aortic valve replacement: the benchmark for percutaneous therapies

Pietro Bajona1, Rakesh M Suri1, Kevin L Greason1

  • 1Division of Cardiovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN.

Progress in Cardiovascular Diseases
|May 20, 2014
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) offers an alternative for severe aortic stenosis (AS) patients previously deemed inoperable. Outcomes for TAVR in high-risk AS patients show benefits, with intermediate-risk data pending clinical trials.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Valvular Heart Disease

Background:

  • Severe senile calcific aortic stenosis (AS) historically excluded many patients from surgical aortic valve replacement (SAVR) due to high perceived operative risks.
  • These patients were often classified as 'high risk' or 'inoperable' for SAVR.
  • The advent of transcatheter aortic valve replacement (TAVR) provides a new treatment avenue and necessitates re-evaluation of risk assessment strategies.

Purpose of the Study:

  • To examine current outcomes for surgical aortic valve replacement (SAVR) in high- and intermediate-risk patients with aortic stenosis (AS).
  • To use SAVR outcomes as a benchmark for evaluating emerging percutaneous therapies like transcatheter aortic valve replacement (TAVR).
  • To discuss the evolving role of TAVR in managing AS across different risk strata.

Main Methods:

  • Review of current literature and clinical outcomes data for SAVR in high- and intermediate-risk AS populations.
  • Comparative analysis of SAVR results with emerging data on TAVR efficacy and safety.
  • Discussion of risk stratification algorithms in the context of new treatment options.

Main Results:

  • TAVR has demonstrated benefits in high-risk AS patients.
  • The efficacy of TAVR in intermediate-risk AS patients is still under investigation, awaiting results from ongoing clinical trials.
  • SAVR remains a critical consideration for specific patient groups, providing a basis for comparison.

Conclusions:

  • TAVR is a viable alternative for high-risk patients with severe aortic stenosis (AS).
  • Further clinical trials are essential to clarify the role and outcomes of TAVR in intermediate-risk AS patients.
  • SAVR outcomes serve as an important reference point for assessing the progress of percutaneous valve therapies.

Keywords:
Aortic stenosisAortic valve replacementSurgeryTranscatheter aortic valve replacement

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