Contemporary risk models for transcatheter aortic valve replacement: A narrative review

Aortic stenosis (AS) is the most common form of valvular heart disease in older adults requiring intervention. Severe symptomatic AS, if left untreated, is typically associated with a poor prognosis. Over the past two decades, there have been significant advances in the field of transcatheter aortic valve replacement (TAVR), leading to its emergence as an alternative to the well-established surgical aortic valve replacement (SAVR) for treating severe AS. Multiple randomized clinical trials have demonstrated comparable efficacy and safety outcomes of TAVR vs SAVR in high, intermediate, and low-risk surgical candidates. In the process, multiple risk scores, both traditional surgical and TAVR-specific, have been developed to better risk stratify patients as well as guide periprocedural management and patient counseling. This review aims to discuss the currently available risk models for risk prediction in TAVR patients, highlighting their strengths, limitations, and applicability to different patient populations.