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Review
. 2023 Apr 15:193:1-18.
doi: 10.1016/j.amjcard.2023.01.040. Epub 2023 Feb 27.

TAVR in 2023: Who Should Not Get It?

Sukhdeep Bhogal  1 , Toby Rogers  2 , Amer Aladin  1 , Itsik Ben-Dor  1 , Jeffrey E Cohen  3 , Christian C Shults  3 , Jason P Wermers  1 , Gaby Weissman  4 , Lowell F Satler  1 , Michael J Reardon  5 , Steven J Yakubov  6 , Ron Waksman  7
Affiliations
Review

TAVR in 2023: Who Should Not Get It?

Sukhdeep Bhogal et al. Am J Cardiol. .

Abstract

Since the first transcatheter delivery of an aortic valve prosthesis was performed by Cribier et al in 2002, the picture of aortic stenosis (AS) therapeutics has changed dramatically. Initiated from an indication of inoperable to high surgical risk, extending to intermediate and low risk, transcatheter aortic valve replacement (TAVR) is now an approved treatment for patients with severe, symptomatic AS across all the risk categories. The current evidence supports TAVR as a frontline therapy for treating severe AS. The crucial question remains concerning the subset of patients who still are not ideal candidates for TAVR because of certain inherent anatomic, nonmodifiable, and procedure-specific factors. Therefore, in this study, we focus on these scenarios and reasons for referring selected patients for surgical aortic valve replacement in 2023.

Keywords: Aortic annulus; Bicuspid aortic valve; Severe aortic stenosis; Surgical aortic valve replacement; Transcatheter aortic valve replacement.

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Conflict of interest statement

Disclosures Dr. Reardon is a consultant for Medtronic, Boston Scientific, Abbott Medical, and Gore Medical. Steven J. Yakubov is a consultant for Medtronic, Boston Scientific, and Foldax. Dr. Rogers reports being a proctor and consultant for Boston Scientific, Edwards Lifesciences, and Medtronic; serving on the Advisory Board of Medtronic; and holding equity interest in Transmural Systems Inc. Dr. Waksman reports serving on the advisory boards of Abbott Vascular, Boston Scientific, Medtronic, Philips IGT, and Pi-Cardia Ltd; being a consultant for Abbott Vascular, Biotronik, Boston Scientific, Cordis, Medtronic, Philips IGT, Pi-Cardia Ltd, Swiss Interventional Systems/SIS Medical AG, Transmural Systems Inc, and Venus MedTech; receiving institutional grant support from Amgen, Biotronik, Boston Scientific, Chiesi, Medtronic, and Philips IGT; and being an investor in MedAlliance and Transmural Systems Inc. The remaining authors have no conflicts of interest to declare.

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