The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)
Transcatheter aortic valve replacement: a surgeon's perspective
Allan S. Stewart1*, MD; Craig R. Smith1, MD
1. Columbia University Medical Center, New York, New York, USA
Aortic valve replacement (AVR) is the only effective treatment in adults with symptomatic aortic stenosis. The operation unequivocally extends life and relieves symptoms1. The operative mortality for isolated AVR in the Society of Thoracic Surgeons (STS) National Database, as well as in the New York State database, is 3%. Even lower operative mortality has been reported from centres of excellence2. Additionally, surgical AVR is a durable procedure, with currently available bioprosthetic valves demonstrating improved freedom from structural valve disease3. Despite these data, many patients with severe aortic stenosis are never referred for surgical consultation, due to perceived prohibitive operative risk, or ...