DIAGNOSIS AND PATIENT SELECTION TRANSCATHETER AORTIC VALVE Replacement (TAVR)
The mechanism of calcific aortic stenosis is similar to atherosclerosis.1
A healthy aortic valve functions properly, opening and closing without being impeded by calcium deposits.
The performance of a stenotic aortic valve is impeded by calcium deposits on the leaflets.
Aortic stenosis is predominantly a degenerative disease relative to other types of heart valve disease such as aortic regurgitation, mitral stenosis, and mitral regurgitation.1
Approximately 300,000 people in the U.S. are diagnosed annually with symptomatic severe aortic stenosis.2 Aortic stenosis is the most prevalent native valve disease.3
Onset of dyspnea and other heart failure symptoms foretell the worst outlook for aortic stenosis patients.4 Classic symptoms of aortic stenosis include angina, syncope, and heart failure. After becoming symptomatic with signs of heart failure, the average patient survival is two years without treatment.4
Indication for intervention in patients with valvular heart disease is dependent on:5
According to the AHA/ACC guidelines,5 physicians should nearly always consider intervention for otherwise healthy patients with severe valvular heart disease who become symptomatic. Further, the AHA/ACC Class I Recommendation provides that patients with severe valvular heart disease should be evaluated by a multidisciplinary heart valve team when intervention is considered.
Your patient’s situation will guide your treatment. Options include:
Mohler, EH, et al. Development and Progression of Aortic Valve Stenosis: Atherosclerosis Risk Factors-a Causal Relationship? A Clinical Morphologic Study, Clin Cardiol.1991;14:995999.
Medtronic data on file.
lung B. A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. Eur Heart J. 2003;24:1231-1243.
Lester SJ, Heilbron B, Gin K, et al. The natural history and rate of progression of aortic stenosis. Chest 1998; 113:1109-14.
Nishimura RA, et al. Circulation. 2014;129:2440-2492; Nishimura RA, et al. Circulation. 2017;135:e1159-e1195.