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Updated: Feb 27, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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TAVR vs SAVR: Rising Expectations and Changing Indications for Surgery in Response to PARTNER II.

Cristiano Spadaccio1, Francesco Nappi2, Jean-Louis Sablayrolles3

  • 1Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.

Seminars in Thoracic and Cardiovascular Surgery
|July 8, 2017
PubMed
Summary

The PARTNER II trial highlights a shift in aortic valve disease management, pushing surgical aortic valve replacement (SAVR) towards less invasive approaches. This revolution necessitates evolving SAVR techniques to compete with transcatheter alternatives.

Keywords:
PARTNER II trialminimally invasive surgerysurgical aortic valve replacementtranscatheter aortic valve replacement

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Aortic valve disease management is undergoing significant transformation.
  • Conventional full sternotomy surgical aortic valve replacement (SAVR) faces challenges due to complications and clinical burden.
  • Transcatheter aortic valve replacement (TAVR) has emerged as a major alternative.

Purpose of the Study:

  • To analyze the PARTNER II trial findings in the context of evolving aortic valve disease treatment.
  • To re-evaluate the role of SAVR and interventional procedures in light of new data.
  • To explore strategies for improving surgical aortic valve replacement (SAVR) and its competitiveness.

Main Methods:

  • Review and analysis of data from the PARTNER II trial and related studies.
  • Examination of recent findings on transcatheter valve durability, thrombosis, and complications.
  • Discussion of comparative effectiveness and procedural advancements.

Main Results:

  • The PARTNER II trial, despite criticisms, indicates a paradigm shift favoring less invasive options.
  • Surgical aortic valve replacement (SAVR) requires innovation to remain a viable option.
  • Transcatheter valve technology is advancing, impacting treatment decisions.

Conclusions:

  • Aortic valve disease management is evolving, with transcatheter procedures gaining prominence.
  • Surgical aortic valve replacement (SAVR) must adapt by embracing minimally invasive techniques.
  • A behavioral shift in the surgical community is needed to integrate new approaches and maintain competitiveness.