Treatment of the Aortic Valve in the Modern Era—A Review of TAVR vs. SAVR

Aortic stenosis (AS) is the most common valve disease in developed countries, with severe cases traditionally managed through surgical aortic valve replacement (SAVR). More recently, transcatheter aortic valve replacement (TAVR) has been used as a less invasive alternative, especially for patients d...

Full description

Saved in:
Bibliographic Details
Main Authors: Albert Dweck, Brandon E. Ferrell, Daniel Guttman, Stephen M. Spindel, Tadahisa Sugiura
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Surgeries
Subjects:
Online Access:https://www.mdpi.com/2673-4095/6/1/4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850279831469555712
author Albert Dweck
Brandon E. Ferrell
Daniel Guttman
Stephen M. Spindel
Tadahisa Sugiura
author_facet Albert Dweck
Brandon E. Ferrell
Daniel Guttman
Stephen M. Spindel
Tadahisa Sugiura
author_sort Albert Dweck
collection DOAJ
description Aortic stenosis (AS) is the most common valve disease in developed countries, with severe cases traditionally managed through surgical aortic valve replacement (SAVR). More recently, transcatheter aortic valve replacement (TAVR) has been used as a less invasive alternative, especially for patients deemed high-risk for surgery. This review aims to compare SAVR and TAVR by examining the efficacy, patient selection criteria, complications, and evolving guidelines. SAVR is the preferred option for patients at low surgical risk or with anatomical challenges unsuitable for TAVR. It offers well-documented durability and favorable long-term survival. Conversely, TAVR has gained acceptance for intermediate- and high-risk patients, with shorter recovery times and reduced immediate postoperative risks. However, questions surrounding its long-term durability in younger populations persist. Complications differ between the approaches, with TAVR associated with vascular access injuries and arrhythmic events, while SAVR presents risks tied to open surgery. As clinical guidelines evolve, patient age, comorbidities, and life expectancy play critical roles in determining the optimal intervention. This review highlights the need for tailored treatment approaches, given the expanding indications and evolving evidence for both SAVR and TAVR in AS management.
format Article
id doaj-art-73699a75ff1640b782b7d372d3e7f542
institution OA Journals
issn 2673-4095
language English
publishDate 2024-12-01
publisher MDPI AG
record_format Article
series Surgeries
spelling doaj-art-73699a75ff1640b782b7d372d3e7f5422025-08-20T01:48:58ZengMDPI AGSurgeries2673-40952024-12-0161410.3390/surgeries6010004Treatment of the Aortic Valve in the Modern Era—A Review of TAVR vs. SAVRAlbert Dweck0Brandon E. Ferrell1Daniel Guttman2Stephen M. Spindel3Tadahisa Sugiura4Albert Einstein College of Medicine, Bronx, NY 10461, USADepartment of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, NY 10467, USAAlbert Einstein College of Medicine, Bronx, NY 10461, USADepartment of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, NY 10467, USADepartment of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, NY 10467, USAAortic stenosis (AS) is the most common valve disease in developed countries, with severe cases traditionally managed through surgical aortic valve replacement (SAVR). More recently, transcatheter aortic valve replacement (TAVR) has been used as a less invasive alternative, especially for patients deemed high-risk for surgery. This review aims to compare SAVR and TAVR by examining the efficacy, patient selection criteria, complications, and evolving guidelines. SAVR is the preferred option for patients at low surgical risk or with anatomical challenges unsuitable for TAVR. It offers well-documented durability and favorable long-term survival. Conversely, TAVR has gained acceptance for intermediate- and high-risk patients, with shorter recovery times and reduced immediate postoperative risks. However, questions surrounding its long-term durability in younger populations persist. Complications differ between the approaches, with TAVR associated with vascular access injuries and arrhythmic events, while SAVR presents risks tied to open surgery. As clinical guidelines evolve, patient age, comorbidities, and life expectancy play critical roles in determining the optimal intervention. This review highlights the need for tailored treatment approaches, given the expanding indications and evolving evidence for both SAVR and TAVR in AS management.https://www.mdpi.com/2673-4095/6/1/4aortic valvesurgical aortic valve replacementtranscatheter aortic valve replacementtranscatheteraortic valve replacementaortic stenosis
spellingShingle Albert Dweck
Brandon E. Ferrell
Daniel Guttman
Stephen M. Spindel
Tadahisa Sugiura
Treatment of the Aortic Valve in the Modern Era—A Review of TAVR vs. SAVR
Surgeries
aortic valve
surgical aortic valve replacement
transcatheter aortic valve replacement
transcatheter
aortic valve replacement
aortic stenosis
title Treatment of the Aortic Valve in the Modern Era—A Review of TAVR vs. SAVR
title_full Treatment of the Aortic Valve in the Modern Era—A Review of TAVR vs. SAVR
title_fullStr Treatment of the Aortic Valve in the Modern Era—A Review of TAVR vs. SAVR
title_full_unstemmed Treatment of the Aortic Valve in the Modern Era—A Review of TAVR vs. SAVR
title_short Treatment of the Aortic Valve in the Modern Era—A Review of TAVR vs. SAVR
title_sort treatment of the aortic valve in the modern era a review of tavr vs savr
topic aortic valve
surgical aortic valve replacement
transcatheter aortic valve replacement
transcatheter
aortic valve replacement
aortic stenosis
url https://www.mdpi.com/2673-4095/6/1/4
work_keys_str_mv AT albertdweck treatmentoftheaorticvalveinthemoderneraareviewoftavrvssavr
AT brandoneferrell treatmentoftheaorticvalveinthemoderneraareviewoftavrvssavr
AT danielguttman treatmentoftheaorticvalveinthemoderneraareviewoftavrvssavr
AT stephenmspindel treatmentoftheaorticvalveinthemoderneraareviewoftavrvssavr
AT tadahisasugiura treatmentoftheaorticvalveinthemoderneraareviewoftavrvssavr