TY - JOUR
T1 - Current key issues in transcatheter aortic valve replacement undergoing a paradigm shift
AU - Hwang, In Chang
AU - Hayashida, Kentaro
AU - Kim, Hyo Soo
N1 - Funding Information:
This study was supported by a grant of Korea Health Technology R&D Project (HI 17C2085 & HI14C1277) through the Korea Health Industry Development Institute (KHIDI) funded by the Ministry of Health & Welfare (MHW), Republic of Korea.
Publisher Copyright:
© 2019, Japanese Circulation Society. All rights reserved.
PY - 2019
Y1 - 2019
N2 - As a new technology in the management of valvular heart disease, transcatheter aortic valve replacement (TAVR) has drawn much attention since its emergence. To date, numerous studies have investigated the safety and efficacy of TAVR in patients of various risk profiles with severe aortic stenosis (AS) and demonstrated comparable or superior outcomes of TAVR when compared with surgical aortic valve replacement (SAVR). The favorable outcomes of TAVR in inoperable patients, as well as in high- and intermediaterisk patients, are endorsed in current guidelines, and trials of low-risk patients have shown non-inferior or even superior results of TAVR than for SAVR, suggesting that the clinical indications of TAVR can be expanded to low-risk patients. Moreover, a therapeutic role of TAVR has been suggested in various aortic valve (AV) diseases, such as bicuspid AV, moderate AS with heart failure, aortic regurgitation, and bioprosthetic valve failure. In this review, we summarize the current issues of TAVR in various patient populations and discuss the expanding clinical indications of TAVR, which are driving a major paradigm shift in the management of AV disease.
AB - As a new technology in the management of valvular heart disease, transcatheter aortic valve replacement (TAVR) has drawn much attention since its emergence. To date, numerous studies have investigated the safety and efficacy of TAVR in patients of various risk profiles with severe aortic stenosis (AS) and demonstrated comparable or superior outcomes of TAVR when compared with surgical aortic valve replacement (SAVR). The favorable outcomes of TAVR in inoperable patients, as well as in high- and intermediaterisk patients, are endorsed in current guidelines, and trials of low-risk patients have shown non-inferior or even superior results of TAVR than for SAVR, suggesting that the clinical indications of TAVR can be expanded to low-risk patients. Moreover, a therapeutic role of TAVR has been suggested in various aortic valve (AV) diseases, such as bicuspid AV, moderate AS with heart failure, aortic regurgitation, and bioprosthetic valve failure. In this review, we summarize the current issues of TAVR in various patient populations and discuss the expanding clinical indications of TAVR, which are driving a major paradigm shift in the management of AV disease.
KW - Aortic stenosis
KW - Surgical aortic valve replacement
KW - Transcatheter aortic valve implantation
KW - Transcatheter aortic valve replacement
KW - Valve-in-valve
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U2 - 10.1253/circj.CJ-19-0096
DO - 10.1253/circj.CJ-19-0096
M3 - Article
C2 - 30956265
AN - SCOPUS:85065219426
VL - 83
SP - 952
EP - 962
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 5
ER -