Transcatheter and surgical aortic valve replacement in patients at low surgical risk. Review of major studies
B. S. Tsaroev,
A. V. Bogachev-Prokofiev,
S. I. Zheleznev,
R. M. Sharifulin,
A. S. Zalesov,
A. M. Chernyavsky https://doi.org/10.15829/1560-4071-2024-6188
EDN: ZHJVOF
Abstract
In recent decades, transcatheter aortic valve replacement (TAVR) has become a revolutionary method for the treatment of severe aortic stenosis, especially for patients at high surgical risk. Studies such as PARTNER and SURTAVI have confirmed the non-inferiority or superiority of TAVR compared with surgical aortic valve replacement in various risk categories. Newer technologies, including third-generation valve systems, have improved durability and reduced complications such as paravalvular regurgitation. However, long-term survival data remain limited, especially for younger patients and groups with anatomical peculiarities. International association guidelines have long favored TAVR for older patients, while surgery remains the preferred option for younger patients with low surgical risk. However, the latter point is increasingly being questioned. The article analyzes key studies, discusses current limitations, and highlights the need for long-term data to inform clinical practice. In conclusion, TAVR is a remarkable achievement in interventional cardiology, but its optimal use requires consideration of individual patient factors.
Supporting agencies: The study was supported by the Russian Science Foundation, grant № 23-15-00434.
About the Authors
B. S. Tsaroev
Meshalkin National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
Novosibirsk
Competing Interests:
None
A. V. Bogachev-Prokofiev
Meshalkin National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
Novosibirsk
Competing Interests:
None
S. I. Zheleznev
Meshalkin National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
Novosibirsk
Competing Interests:
None
R. M. Sharifulin
Meshalkin National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
Novosibirsk
Competing Interests:
None
A. S. Zalesov
Meshalkin National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
Novosibirsk
Competing Interests:
None
A. M. Chernyavsky
Meshalkin National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
Novosibirsk
Competing Interests:
None
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Supplementary files
- Transcatheter aortic valve replacement (TAVR) has proven to be an effective alternative to surgical aortic valve replacement, especially for patients with high and moderate surgical risk.
- Long-term outcomes of TAVR, especially for younger patients, remain limited. Valve durability and survival require further research, especially in low surgical risk groups.
- Studies such as PARTNER 3 have limitations in extrapolating results to younger patients. In real-world practice, patients and physicians are more likely to choose TAVR despite the lack of long-term data.
Review
For citations:
Tsaroev B.S., Bogachev-Prokofiev A.V., Zheleznev S.I., Sharifulin R.M., Zalesov A.S., Chernyavsky A.M. Transcatheter and surgical aortic valve replacement in patients at low surgical risk. Review of major studies. Russian Journal of Cardiology. 2024;29(12):6188. (In Russ.) https://doi.org/10.15829/1560-4071-2024-6188. EDN: ZHJVOF
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