Abstract
The advent of transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis and established a life-prolonging therapy in patients that are not operative candidates. It is also approved for high-risk surgical candidates and shows effectiveness comparable to surgical aortic valve replacement (SAVR).
The inoperable and high-risk groups represent two parallel but partly divergent populations. In those deemed inoperable, decisions revolve around offering TAVR, palliation, or rehabilitation. These are based primarily on the likelihood of procedural success and clinical benefit, with a careful assessment of the source of their debility and features that underlie extreme surgical risk. In patients that are at high-risk for SAVR, determination of the most favorable route of valve replacement is guided by comparative procedural characteristics, the need for coincident interventions, and presumed ability for rehabilitation.
These decisions are inherently difficult and currently rely on imperfect but developing risk assessment systems. Given the complexity of these decisions and patient population, the TAVR experience has underscored the value of a multi-disciplinary approach to advanced cardiovascular disease.
Keywords: Aortic stenosis, risk assessment, multi-disciplinary, frailty, aortic valve replacement, patient selection.
Current Pharmaceutical Design
Title:Algorithms and Criteria for Transcatheter Aortic Valve Replacement Patient Selection: Current Status and Future Trends
Volume: 22 Issue: 13
Author(s): Scott M Lilly and William T Abraham
Affiliation:
Keywords: Aortic stenosis, risk assessment, multi-disciplinary, frailty, aortic valve replacement, patient selection.
Abstract: The advent of transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis and established a life-prolonging therapy in patients that are not operative candidates. It is also approved for high-risk surgical candidates and shows effectiveness comparable to surgical aortic valve replacement (SAVR).
The inoperable and high-risk groups represent two parallel but partly divergent populations. In those deemed inoperable, decisions revolve around offering TAVR, palliation, or rehabilitation. These are based primarily on the likelihood of procedural success and clinical benefit, with a careful assessment of the source of their debility and features that underlie extreme surgical risk. In patients that are at high-risk for SAVR, determination of the most favorable route of valve replacement is guided by comparative procedural characteristics, the need for coincident interventions, and presumed ability for rehabilitation.
These decisions are inherently difficult and currently rely on imperfect but developing risk assessment systems. Given the complexity of these decisions and patient population, the TAVR experience has underscored the value of a multi-disciplinary approach to advanced cardiovascular disease.
Export Options
About this article
Cite this article as:
Lilly M Scott and Abraham T William, Algorithms and Criteria for Transcatheter Aortic Valve Replacement Patient Selection: Current Status and Future Trends, Current Pharmaceutical Design 2016; 22 (13) . https://dx.doi.org/10.2174/1381612822666151208121437
DOI https://dx.doi.org/10.2174/1381612822666151208121437 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Statins and Vulnerable Plaque
Current Pharmaceutical Design Endothelial Progenitors in Vascular Repair and Angiogenesis: How Many are Needed and What to do?
Cardiovascular & Hematological Disorders-Drug Targets Stress, Cardiovascular Diseases and Surgery-Induced Angiogenesis
Current Angiogenesis (Discontinued) Pesticides-induced Cardiovascular Dysfunctions: Prevalence and Associated Mechanisms
Current Hypertension Reviews Interactive Effect of Combined Exposure to Active and Passive Smoking on Cardiovascular System
Recent Patents on Cardiovascular Drug Discovery GRK2 and Beta-Arrestins in Cardiovascular Disease: Established and Emerging Possibilities for Therapeutic Targeting
Current Molecular Pharmacology What is Tobacco Smoke? Sociocultural Dimensions of the Association with Cardiovascular Risk
Current Pharmaceutical Design MicroRNA-34a Promotes Cardiomyocyte Apoptosis Post Myocardial Infarction Through Down-regulating Aldehyde Dehydrogenase 2
Current Pharmaceutical Design Role of the Wnt/β-Catenin Pathway in the Pathogenesis of Alcoholic Liver Disease
Current Molecular Pharmacology Cardiac Amyloid - A Hidden Contributor to Cardiac Dysfunction Following Cardiac Surgery: Case Report and Literature Review
Current Cardiology Reviews Regulation of Self-Reactive T Cells by Human Immunoglobulins- Implications for Multiple Sclerosis Therapy
Current Pharmaceutical Design Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Cardiac Structural and Electrical Remodeling: From Myocardial Cytology to Cardiodiabetology
Current Vascular Pharmacology Inflammatory Markers in Coronary Artery Disease: Pathophysiological Mechanisms, Prognostic and Therapeutic Implications
Current Cardiology Reviews Treatment Approaches in Elderly Patients with Head and Neck Cancer
Anti-Cancer Agents in Medicinal Chemistry MicroRNAs in Organogenesis and Disease
Current Molecular Medicine Role of miRNAs in Muscle Stem Cell Biology: Proliferation, Differentiation and Death
Current Pharmaceutical Design Hypertensive Left Ventricular Hypertrophy Regression: Does It Matter?
Current Hypertension Reviews RAGE: A Multi-Ligand Receptor Unveiling Novel Insights in Health and Disease
Current Medicinal Chemistry Protective Effects of Curcumin against Iron-induced Toxicity
Current Pharmaceutical Biotechnology Advanced Glycation: How are we Progressing to Combat this Web of Sugar Anomalies in Diabetic Nephropathy
Current Pharmaceutical Design