Lifetime Management for Aortic Stenosis: Strategy and Decision Making in the Current Era.

Overview

Aortic stenosis (AS), the most common valvular disease in the western world has been traditionally treated with surgical aortic valve replacement (SAVR) but is increasingly treated by transcatheter aortic valve replacement (TAVR). While patients over age 65 are preferably treated with bioprosthetic tissue valves, there is considerable uncertainty in the choice between TAVR and SAVR. We present various considerations for optimizing the life-long management of patients receiving bioprosthetic valves (SAVR or TAVR). To maximize life expectancy and minimize cumulative lifetime risk, we suggest decision making individualized for patient anatomy and overall (current and future) risk.