[Aortic valvular replacement by catheterism. Current state]

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Severe aortic stenosis prevalence increases with aging populations.
• Surgical aortic valve replacement (SAVR) was the primary treatment.
• Transcatheter aortic valve replacement (TAVR) emerged as an alternative.

Purpose of the Study:

• To evaluate the effectiveness and safety of TAVR compared to traditional treatments.
• To assess TAVR's role in different patient risk categories.
• To identify remaining challenges and future directions for TAVR.

Main Methods:

• Review of randomized clinical trials and patient registries.
• Comparison of TAVR outcomes against conservative medical treatment.
• Analysis of TAVR versus SAVR in high, intermediate, and low surgical risk patients.

Main Results:

• TAVR demonstrated superiority over medical treatment in non-surgical candidates.
• TAVR proved non-inferior to SAVR in high-risk patients.
• Effectiveness was similar across risk groups, with reduced complications like stroke and vascular issues.

Conclusions:

• TAVR is a viable and effective treatment option for severe aortic stenosis.
• Technical advancements have improved TAVR safety and reduced complications.
• Long-term durability of TAVR remains a critical area for ongoing research.