How do the recommendations for surgical and transcatheter intervention for aortic stenosis (AS) compare?

Updated: May 07, 2019
  • Author: Xiushui (Mike) Ren, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

A comparison of recommendations for surgical and transcatheter intervention for AS is provided in Table 4, below.

Table 4. Guideline Recommendations for Aortic Stenosis Intervention (Open Table in a new window)

Intervention Selection

AHA/ACC (2014) [6]

ESC/EACTS (2012) [5]

STS(2013) [53]

Surgical AVR in patients with low or intermediate surgical risk

Class I

Class I

 

Transcatheter aortic valve replacement (TAVR) for patients who have a prohibitive surgical risk and a predicted post-TAVR survival >12 mo

Class I

Class I

Class I

TAVR for patients who have high surgical risk

Class IIa-Reasonable

Class IIa-Reasonable

 

TAVR is not recommended in patients in whom existing comorbidities would preclude the expected benefit from correction of AS

Class III

Class III

 

Balloon aortic valvuloplasty (BAV) as a bridge to surgical AVR or TAVR in severely symptomatic patients

Class IIb-Consider

Class IIb-Consider

Class IIa-Reasonable

BAV as bridge to AVR in hemodynamically unstable patients with severe AS where immediate AVR is not feasible

 

Class IIb-Consider

Class IIa-Reasonable

BAV in severely symptomatic patients where AVR is not an option for symptom relief

   

Class IIb-Consider

BAV as a palliative measure when surgery is contraindicated because of severe comorbidities

 

Class IIb-Consider

Class IIb-Consider


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