Key Points
����The most common cause of valvular aortic stenosis (AS) in adults is
calcification of a normal tricuspid or congenital bicuspid valve.
����Calcific AS typically presents in older individuals (ie, >75 years) in contrast
to bicuspid AS, which presents a decade or more earlier.
����Stroke, the greatest risk accompanying aortic valve replacement (AVR), can
be kept under 2% even in octogenerians by careful patient selection.
����Transcatheter aortic valve replacement (TAVR) offers new and potentially
transformational technology for patients with severe aortic valvular stenosis
who are either extremely high-risk candidates or inoperable for surgical
AVR or who are inoperable by virtue of associated comorbidities.
����An estimated 40,000 patients have received TAVR worldwide.
Aortic Stenosis
������ Predicted survial ���
<12 months
������ Prohibitive TAVR risk
������ Severe
������ Symptomatic
Medical treatment
including the
potential for balloon
valvuloplasty
������ Tricuspid valve
������ Prohibitive
surgical risk
OR
High surgical risk
������ Severe
������ Hypotensive response to exercise
������ Moderate
������ Symptomatic
������ Need for related CV Surgery
������ Critical Aortic Stenosis
TAVR
AVR
