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The less complex the case is, the more complex is it to choose? The case of lower risk patients with aortic valve stenosis
Author(s) -
Lemos Pedro A.,
Makdisse Marcia
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27771
Subject(s) - medicine , valve replacement , stenosis , stroke (engine) , aortic valve stenosis , aortic valve , aortic valve replacement , cardiology , surgery , mechanical engineering , engineering
Key Points Clinical evidences that prove the value of transcatheter aortic valve replacement (TAVR) for high‐risk patients cannot be directly extrapolated to good candidates for surgery. Studies specifically designed to evaluate TAVR in low‐to‐intermediate‐risk patients should go beyond traditional clinical outcomes to also include, amongst others, endpoints related to patient‐reported outcome measures (PROMs), such as quality of life and functional status, and a cost analysis over the full cycle of care aiming at demonstrating value on outcomes that matter most to patients. In this issue of CCI, Garcia and coworkers report on the outcomes of intermediate‐risk patients treated with either TAVR or surgical aortic valve replacement, showing that TAVR was associated with an improvement in clinical outcomes compared to surgery, with lower 30‐day mortality and stroke rates, shorter hospital lengths and higher proportions of patients being discharged home.