[Aortic Valve Stenosis: When to Treat Interventionally, when Surgically?]

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Cardiac Surgery

Background:

• Severe aortic stenosis management traditionally relies on surgical aortic valve replacement (SAVR).
• Transcatheter aortic valve implantation (TAVI) is a recognized first-line therapy for high-risk patients.
• Emerging data supports TAVI's non-inferiority to SAVR in intermediate and low-risk populations.

Purpose of the Study:

• To review the decision-making process for severe aortic stenosis treatment.
• To present a diagnostic algorithm for patient stratification.
• To provide criteria for a differentiated therapeutic approach based on recent evidence.

Main Methods:

• Review of current clinical guidelines and recent trial data.
• Analysis of diagnostic criteria for assessing aortic stenosis severity and patient risk.
• Synthesis of evidence comparing SAVR and TAVI outcomes.

Main Results:

• TAVI is established for high-risk patients and shows comparable efficacy to SAVR in intermediate and low-risk groups.
• An increasing volume of transcatheter procedures is projected.
• Recent data supports a broader application of TAVI.

Conclusions:

• A structured diagnostic and decision-making process is crucial for optimizing severe aortic stenosis treatment.
• TAVI is becoming a viable alternative across a wider spectrum of surgical risk.
• Further evaluation of patient-specific factors will refine treatment selection.