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Aortic Stenosis-Associated Cardiac Damage: A Comparison Between Patients Treated with Surgery and Transcatheter

Ricardo Román1, Fabián Islas2, Patrick O'Neill-González1

  • 1Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.

Journal of Clinical Medicine
|March 14, 2026
PubMed

Insights

Patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS) show more extensive cardiac damage than surgical aortic valve replacement (SAVR) patients. Earlier intervention before advanced damage may improve outcomes.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Interventional Cardiology

Background:

  • Severe aortic stenosis (AS) can lead to extra-valvular cardiac damage.
  • This damage is linked to patient outcomes after aortic valve interventions.

Purpose of the Study:

  • To compare AS-related cardiac damage between surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) patients.
  • To analyze the impact of cardiac damage stages on 1-year mortality post-intervention.

Main Methods:

  • Retrospective analysis of 874 patients with severe AS undergoing SAVR or TAVR (2017-2022).
  • Comparison of pre-intervention clinical and echocardiographic parameters.
  • Classification of patients using Généreux and Gutiérrez-Ortiz staging systems for cardiac damage.
  • Assessment of 1-year all-cause mortality based on damage stages.

Main Results:

  • TAVR patients were older, more frequently female, and had higher surgical risk than SAVR patients.
  • TAVR patients exhibited significantly more advanced cardiac damage (right-sided) compared to SAVR patients, per both staging systems.
  • Higher mortality was observed in patients with right-sided damage, irrespective of intervention type or staging system.

Conclusions:

  • Contemporary severe symptomatic AS patients treated with TAVR present with more extensive cardiac damage than SAVR patients.
  • This highlights the importance of intervention timing, particularly for TAVR candidates.
  • Earlier intervention prior to advanced cardiac damage may lead to improved patient outcomes.

Keywords:
and echocardiographyaortic stenosiscardiac damagestagingsurgical aortic valve replacementtranscatheter aortic valve replacement

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