Aortic Valve Replacement in the Current Era

Abstract

Aortic valve disease (AVD) is a highly prevalent condition worldwide. Aortic valve replacement (AVR) is the surgical treatment for those with severe disease. Common etiologies of AVD include aortic stenosis (AS), aortic insufficiency (AI), endocarditis, and congenital diseases. Shared decision-making plays a large role in the treatment methodology chosen for each patient. Selection of valve type and surgical intervention requires strong considerations of age and compatibility with vitamin K antagonists (VKAs) to ensure optimal post-operative outcomes. Due to the development of novel surgical techniques, including transcatheter AVR (TAVR) and placement of sutureless valves, patients who previously had limited access to AVD surgical options can now be considered for AVR. Further research into therapeutic development is imperative to improve patient short- and long-term outcomes as well as widen surgical candidacy for those seeking AVR for the management of AVD. Overall, AVR will continue to hold its prominent role in the treatment of AVD.

Keywords: aortic valve disease; aortic valve replacement; surgical aortic valve replacement; transcatheter aortic valve replacement.

Figure 1

Adaptation of the 2020 ACC/AHA Guidelines for Valve Selection. Acronyms: ACC: American College of Cardiology, AHA: American Heart Association, VKA: Vitamin K Antagonist, CVC: Comprehensive Valve Center.