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JAMA Cardiology Clinical Guidelines Synopsis
September 2017

Guidelines Update on Indications for Transcatheter Aortic Valve Replacement

Author Affiliations
  • 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
  • 2Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 3Associate Editor, JAMA Cardiology
  • 4Brigham and Women’s Hospital, Boston, Massachusetts
  • 5Editor, JAMA Cardiology
JAMA Cardiol. 2017;2(9):1036-1037. doi:10.1001/jamacardio.2017.2546

The development of TAVR has transformed the treatment of patients with symptomatic severe AS. TAVR can now be performed via percutaneous femoral access without the need for general anesthesia or cardiopulmonary bypass, decreasing hospital stay and recovery time. In randomized clinical trials (RCTs), TAVR improved survival and quality of life compared with medical therapy in patients at prohibitive risk for surgery,2 and patients at high risk for surgery had equivalent outcomes with TAVR vs SAVR.3,4 With increasing experience and improvements in technology and patient selection, TAVR has shown equivalence to SAVR in rates of mortality and disabling stroke at 2 years in RCTs of patients with intermediate surgical risk.5,6 Registry studies indicate benefit of TAVR for valve-in-valve treatment of degenerated bioprostheses.7