Expanding indications for TAVR: The preferred procedure in intermediate-risk patients?

Abstract

Transcatheter aortic valve replacement (TAVR) has steadily replaced surgical aortic valve replacement (SAVR) in symptomatic patients with severe aortic stenosis, primarily those at high risk for surgical complications. As TAVR use increases, spurred by technological advances in valve design and patient preferences for the less-invasive procedure, studies have provided data supporting the efficacy and safety of TAVR. Recently, TAVR has expanded to intermediate-risk patients, increasing the potential patient population. Although emerging evidence supports its use in lower-risk patients, some adverse events may limit its adoption in a wider patient population. These include stroke, paravalvular leak, valve durability, valve thrombosis, and need for pacemaker replacement. Ongoing clinical trials are expected to provide answers.