Transcatheter aortic valve replacement or surgical aortic valve replacement: Establishing a middle ground

Abstract

Transcatheter aortic valve replacement (TAVR) has emerged as an established standard of care for patients with severe aortic stenosis (AS), irrespective of their surgical risk. However, despite the continuous advancements over last two decades, there are still significant challenges in field in terms of appropriate selection of patients as well as the valves. While there is no doubt that TAVR has now become the leading mode of treatment for severe AS patients, surgical aortic valve replacement (SAVR) still holds its value for the selective group of patients who are not ideal candidate for the minimally invasive procedure: TAVR. The dilemma is palpable in the clinical field that warrants best approach focusing on the lifetime management of these patients. In the recent metanalysis by Moradi et al, the authors provide a comprehensive insight into TAVR vs SAVR in terms of mortality, procedural complications, and post-procedure adverse events. In this editorial, we shed light on comparative analysis of both modalities to establish a middle ground.

Keywords: Transcatheter aortic valve replacement; Surgical aortic valve replacement Pacemaker implantation; Aortic stenosis; Transcatheter heart valves

Core Tip: In the last few years, transcatheter aortic valve replacement (TAVR) has emerged as a formidable and preferred alternative to surgical aortic valve replacement (SAVR) for the treatment of symptomatic patients with severe aortic stenosis across all risk strata owing to the results of large randomized controlled trials (RCTs). Moradi et al in their metanalysis of RCTs provide a comprehensive insight into TAVR vs SAVR in terms of mortality, procedural complications, and post-procedure adverse events. In this editorial, we discuss the current status of TAVR vs SAVR and shed light on comparative analysis of both modalities to establish a middle ground.