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Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

544
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
544

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Related Experiment Video

Updated: Mar 22, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Advances in Transcatheter Aortic Valve Replacement.

Neal S Kleiman1, Michael J Reardon1

  • 1Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.

Methodist Debakey Cardiovascular Journal
|April 30, 2016
PubMed
Summary

Transcatheter aortic valve replacement (TAVR) offers superior survival for high-risk patients with severe aortic stenosis compared to medical therapy. Newer TAVR valves improve outcomes, addressing concerns like paravalvular leak and pacemaker implantation.

Keywords:
TAVRaortic valveparavalvular leakpermanent pacemaker implantationsevere aortic stenosistranscatheter aortic valve replacement

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Transcatheter aortic valve replacement (TAVR) is increasingly utilized for symptomatic severe aortic stenosis in high-risk surgical candidates.
  • Clinical trials like PARTNER and Medtronic CoreValve demonstrate TAVR's survival benefits over best medical therapy and equivalence/superiority to surgical aortic valve replacement (SAVR) in extreme-risk patients.

Purpose of the Study:

  • To review the evidence supporting TAVR for severe aortic stenosis.
  • To explore current advancements in TAVR technology and implantation.
  • To assess TAVR's role in high- and extreme-risk patient populations.

Main Methods:

  • Review of pivotal clinical trial data (e.g., PARTNER, Medtronic CoreValve U.S. Pivotal IDE trial).
  • Analysis of comparative outcomes between TAVR and SAVR.
  • Evaluation of current trends and new-generation valve technologies.

Main Results:

  • TAVR shows superior survival compared to best medical therapy for extreme-risk patients.
  • TAVR survival is equivalent or superior to SAVR in extreme-risk patients, though long-term durability is unknown.
  • Higher rates of paravalvular leak and permanent pacemaker implantation (with self-expanding valves) are noted with TAVR compared to SAVR.

Conclusions:

  • Strong evidence supports TAVR for symptomatic severe aortic stenosis in high- and extreme-risk patients.
  • Newer TAVR valve generations are actively addressing paravalvular leak and improving implantation reliability.
  • TAVR represents a vital and evolving treatment option for severe aortic stenosis.