Transcatheter Bioprosthetic Aortic Valve Durability: Where do we Stand?
Transcatheter aortic valve implantation (TAVI) was initially reserved for inoperable or high surgical risk patients with severe symptomatic aortic valve stenosis, but after the recent publication of randomized studies comparing TAVI to surgical aortic valve replacement (AVR) among intermediate risk (PARTNER 2 and SURTAVI) and low risk patients (PARTNER 3 and Evolut Low Risk), the momentum for further expansion of TAVI at the expense of AVR seems irreversible. The main obstacle before the wider application of TAVI for intermediate and lower risk patients is the uncertainty regarding bioprosthetic valve durability and the potential for structural deterioration and dysfunction over time. A concise overview regarding bioprosthetic valve durability issues, the relevant current scientific data and their importance for TAVI patient selection and management is herein presented. Rhythmos 2020;15(1):72-76.
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