11
Table 10. Choice of Intervention
Recommendations COR LOE
For patients in whom transcatheter aortic valve replacement
(TAVR) or high-risk surgical AVR is being considered, a heart
valve team consisting of an integrated, multidisciplinary group of
healthcare professionals with expertise in VHD, cardiac imaging,
interventional cardiolog y, cardiac anesthesia, and cardiac surgery
should collaborate to provide optimal patient care.
I C
Surgical AVR is recommended for symptomatic patients with
severe AS (Stage D) and asymptomatic patients with severe AS
(Stage C) who meet an indication for AVR when surgical risk is
low or intermediate.
(Modified recommendation for 2017)
I B-NR
Surgical AVR or TAVR is recommended for symptomatic
patients with severe AS (Stage D) and high risk for surgical
AVR, depending on patient-specific procedural risks, values, and
preferences. (Modified recommendation for 2017)
I A
TAVR is recommended for symptomatic patients with severe
AS (Stage D) and a prohibitive risk for surgical AVR who have
a predicted post-TAVR survival >12 months.
(Modified recommendation for 2017)
I A
TAVR is a reasonable alternative to surgical AVR for
symptomatic patients with severe AS (Stage D) and an
intermediate surgical risk, depending on patient-specific
procedural risks, values, and preferences.
(New recommendation for 2017)
IIa B-R
Percutaneous aortic balloon dilation may be considered as a
bridge to surgical AVR or TAVR for symptomatic patients with
severe AS.
IIb C
TAVR is NOT recommended in patients in whom existing
comorbidities would preclude the expected benefit from
correction of AS.
III: No
Benefit
B
