Aortic Stenosis Connect
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Did you know? Transcatheter aortic valve replacement (TAVR) was initially reserved for high- and intermediate-surgical-risk patients with severe aortic stenosis. The PARTNER 3 and Evolut Low Risk trials independently demonstrated that TAVR achieved non-inferiority — and in PARTNER 3, superiority — to surgical aortic valve replacement in low-risk patients, with primary composite endpoint rates of 8.5% vs. 15.1% (HR 0.54; p<0.001) at 2 years. At 5-year follow-up, TAVR maintained durable valve performance with comparable structural valve deterioration rates.

How are you incorporating updated durability data for TAVR into your heart team discussions for younger, low-risk aortic stenosis patients — particularly regarding lifetime valve management planning?

NCCN Guidelines

How are you incorporating updated durability data for TAVR into your heart team discussions for younger, low-risk aortic stenosis patients — particularly regarding lifetime valve management planning?

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Percutaneous Tricuspid Valve-in-Valve Implantation With Melon Seeding During Deployment. - PubMed

Percutaneous Tricuspid Valve-in-Valve Implantation With Melon Seeding During Deployment. - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/42603160

Percutaneous tricuspid valve-in-valve implantation provides an alternative for high-risk patients with bioprosthetic valve dysfunction.


Percutaneous tricuspid valve-in-valve implantation showed marked symptomatic improvement in a specific case study, reducing transvalvular gradients in high-risk patients.

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Prosthesis-to-Prosthesis Balloon Interaction During TAVR Causing Aorto-Mitral Curtain Injury and Left Ventricular Pseudoaneurysm. - PubMed

Prosthesis-to-Prosthesis Balloon Interaction During TAVR Causing Aorto-Mitral Curtain Injury and Left Ventricular Pseudoaneurysm. - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/42569992

Explore how prosthesis-to-prosthesis interaction during TAVR may cause aorto-mitral curtain injury, and learn about the potential role of conservative management in stable patients.


Prosthesis interaction during TAVR, especially in patients with prior mitral valve replacement, can lead to aorto-mitral curtain injury, as seen in an 82-year-old woman with a 27-mm Medtronic Mosaic valve. Conservative management may be viable in stable patients.

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Structural valve deterioration of a transcatheter aortic bioprosthesis at 4 years in a young adult: a case report. - PubMed

Structural valve deterioration of a transcatheter aortic bioprosthesis at 4 years in a young adult: a case report. - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/42535020

Discover TAVI challenges in young BAV patients, exemplified by a 28-year-old case, and why SAVR remains the preferred intervention.


TAVI poses risks in young BAV patients, like structural valve degeneration, as seen in a 28-year-old. SAVR is recommended for severe AS.

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TAVI durability and lifetime management in aortic stenosis: structural valve deterioration evidence and post-procedural risk stratification

Aortic stenosis (AS) is the most prevalent valvular heart disease in high-income countries. TAVI has expanded from high-surgical-risk to low-risk and younger populations, making long-term bioprosthetic valve durability a central clinical consideration.

Structural valve deterioration (SVD) is the principal factor limiting bioprosthetic valve longevity after TAVI. A 2024 state-of-the-art review shows bioprosthetic valve failure below 5% at midterm (5–8 year) follow-up, comparing favorably to surgical aortic valve replacement. Ten-year randomized trial data suggest comparable TAVI versus SAVR durability, though survivorship bias constrains interpretation. Non-structural dysfunction, including prosthesis-patient mismatch, paravalvular regurgitation, valve thrombosis, and endocarditis, also contributes to valve failure. Post-procedural high-sensitivity troponin-T modeling in a multicenter cohort of 5,158 TAVI patients identified a dynamic early risk trajectory, outperforming fixed-cutoff definitions for 1-year mortality prediction.

Interventional cardiologists, cardiac surgeons, structural heart specialists, and Heart Team members will benefit from peer discussion of TAVI durability evidence, lifetime management strategies, SVD monitoring, and post-procedural risk stratification.

How does evidence on structural valve deterioration and 10-year TAVI durability influence your Heart Team discussions regarding TAVI versus SAVR in younger or low-surgical-risk patients with severe aortic stenosis?

What post-procedural surveillance protocols do you apply following TAVI, and how do you incorporate biomarker trajectories and echocardiographic follow-up into long-term valve monitoring?

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    We review the risks and benefits of the procedure. We especially emphasize to younger patients the advantages of SAVR given the low risk of poor outcomes and better probability of Show More