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Marine Perion¹, Jacques Chan Peng¹, Louen Ropers²

¹Service de cardiologie, Centre Hospitalier Départemental de La Roche-sur-Yon, France.

Annales De Cardiologie Et D'Angeiologie

|September 26, 2025

Summary

Transcatheter aortic valve implantation (TAVI) is now the dominant treatment for severe aortic stenosis (AS), significantly improving patient outcomes. Delays in care for medically treated patients persist, highlighting the need for streamlined management pathways.

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Area of Science:

Cardiology
Interventional Cardiology
Valvular Heart Disease

Background:

Severe calcific aortic stenosis (AS) is a prevalent condition in the elderly with poor prognosis without intervention.
Transcatheter aortic valve implantation (TAVI) has revolutionized treatment strategies since its introduction in 2002.

Purpose of the Study:

To evaluate changes in patient management and outcomes for severe AS.
To compare pre-TAVI, early TAVI integration, and TAVI-dominant eras.
To assess the impact of TAVI on treatment strategies and prognosis.

Main Methods:

Retrospective, single-center observational study.
Inclusion of all hospitalized patients with symptomatic severe AS or reduced left ventricular ejection fraction.

Keywords:

TAVI aortic stenosis cardiac surgery healthcare organization mortality

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Analysis of clinical characteristics, risk scores, management, and one-year outcomes.

Main Results:

Patient numbers increased by 158% from 2005 to 2022.
TAVI became the predominant treatment in 2022 (55%), shifting from surgical dominance in 2005 (67%).
One-year mortality significantly improved with TAVI (5.9%) and surgery (0%) compared to medical therapy (68%) in 2022.

Conclusions:

TAVI integration has transformed AS management, becoming the dominant strategy with improved prognosis.
Medically treated patients continue to face poor outcomes, emphasizing the need for reduced delays.
Streamlining the care pathway is crucial for optimizing outcomes in severe AS patients.