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
Nishimura RA, O’Gara PT, Bonow RO. Guidelines Update on Indications for Transcatheter Aortic Valve Replacement. JAMA Cardiol. 2017;2(9):1036–1037. doi:10.1001/jamacardio.2017.2546
* * SCHEDULED MAINTENANCE * *
The JAMA Network Sites will be conducting routine maintenance from 10/20/2017 through 10/21/2017. During this window access to content and authentication may be intermittently available. The JAMA Store will be completely unavailable during the maintenance window.