Transcatheter Aortic Valve Replacement: A Review

• Published in: The Surgical clinics of North America Vol. 97; no. 4; pp. 899 - 921
• Main Authors: Braxton, John H, Rasmussen, Kelly S, Shah, Milind S
• Format: Journal Article
• Language: English
• Published: United States 01-08-2017
• Subjects: Aortic Valve Stenosis - surgery; Checklist; Heart Valve Prosthesis; Humans; Postoperative Complications - epidemiology; Prosthesis Design; Records as Topic; Risk Assessment; Transcatheter Aortic Valve Replacement - adverse effects; Transcatheter Aortic Valve Replacement - methods; Valvular heart disease; Catheter; Aortic stenosis; Surgical aortic valve replacement; Transcatheter aortic valve replacement
• ISSN: 1558-3171
• DOI: 10.1016/j.suc.2017.03.011

Patients with inoperable, high-risk, and intermediate-risk aortic stenosis can now be treated with transcatheter aortic valve replacement. Centers for Medicare and Medicaid Services and the Food and Drug Administration selectively choose centers based on experience and require a collaborative, multidisciplinary team approach in the treatment and decision making for these patients. The work-up has been streamlined. Gated multislice computed tomography angiogram has emerged as the gold standard for assessment of valve anatomy and sizing of the transcatheter heart valve. Assessment of risk has evolved to include a more comprehensive functional and frailty evaluation. Long term-results are needed before the expansion of transcatheter aortic valve replacement into the low-risk category.