Key Points
ÎÎThe most common cause of valvular aortic stenosis (AS) in adults is
calcification of a normal tricuspid or congenital bicuspid valve.
ÎÎCalcific AS typically presents in older individuals (ie, >75 years) in contrast
to bicuspid AS, which presents a decade or more earlier.
ÎÎStroke, the greatest risk accompanying aortic valve replacement (AVR), can
be kept under 2% even in octogenerians by careful patient selection.
ÎÎTranscatheter 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.
ÎÎAn 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
