Evolving Indications for Transcatheter Aortic Valve Interventions
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Purpose of Review
The purpose of this review was to summarize recent progress in the field of transcatheter aortic valve replacement (TAVR), discuss expansion of indications, and identify areas of future clinical applications.
Favorable clinical outcomes as well as continued refinement of transcatheter heart valve technology have prompted the continuous expansion of indications for TAVR. The results of randomized clinical trials comparing the safety and efficacy of TAVR relative to conventional surgical aortic valve replacement (SAVR) in lower- than high-risk patients have recently been published, and trials among lower-risk categories are ongoing. Furthermore, evidence of the feasibility and safety of TAVR in patients with other pathological conditions is accumulating.
Large pivotal randomized studies support the extension of TAVR to intermediate-risk patients. Moreover, TAVR is emerging as a valuable treatment option for other categories including patients with bicuspid aortic valve, those with pure native aortic regurgitation deemed inoperable, and those with degenerated surgical bioprosthetic valves.
KeywordsTranscatheter aortic valve implantation Indications Low risk Bicuspid aortic valve Aortic regurgitation Failed bioprosthesis
Compliance with Ethical Standards
Conflict of Interest
Anna Franzone declares no conflict of interest.
Thomas Pilgrim reports grants from Edwards Lifesciences, Symetis, and Biotronik.
Stefan Stortecky reports grants to the institution from Boston Scientific, Edwards Lifesciences, Medtronic, St. Jude Medical, and Symetis.
Stephan Windecker reports grants to the institution from Boston Scientific, Bracco Pharmaceutical, Terumo Inc., and St. Jude Medical.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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