Can We Predict Who Will Be Alive and Well After Transcatheter Aortic Valve Replacement? Is That Useful to Individual Patients?

The goal of health care is to optimize both quantity and quality of life for patients. Among select patients with severe symptomatic aortic stenosis, transcatheter aortic valve replacement (TAVR) can, on average, improve both survival and health status (i.e. symptoms, functional status, and quality of life).1,2 Yet, the technology is currently limited to patients who are either ineligible or at high risk for open surgical AVR. The result is that TAVR is used in older patients with multi-morbidity and frailty. As such, success is far from guaranteed for each of these complex cases. Indeed, despite the overall benefits seen in the Placement of AoRTic TraNscathetER Valve (PARTNER) trial, approximately 1 in 5 patients undergoing TAVR died within 6-months.3 An unmet need is to better determine, prior to TAVR, which individual patients are unlikely to achieve a "good" outcome.