Aortic Stenosis: Diagnosis, Molecular Mechanisms and Therapeutic Strategies—A Comprehensive Review

TL;DR

This paper reviews the diagnosis, causes, and treatment options for aortic stenosis, focusing on the shift from traditional surgery to newer minimally invasive procedures.

Contribution

The paper provides a comprehensive overview of current therapeutic strategies and challenges in treating aortic stenosis.

Findings

Transcatheter aortic valve replacement (TAVR) is increasingly used for treating severe aortic stenosis.

TAVR is now authorized for patients with varying surgical risk levels.

Uncertainty remains in choosing between TAVR and surgical aortic valve replacement for older patients.

Abstract

Aortic stenosis (AS) is a progressive valvular heart disease marked by a restriction of blood flow through the aortic valve, resulting in considerable morbidity and mortality if not addressed. AS has historically been managed through surgical aortic valve replacement (SAVR), but there is a growing trend towards the use of transcatheter aortic valve replacement (TAVR). TAVR has transformed the management of symptomatic severe AS and is currently authorized for patients with varying levels of surgical risk. The rising application of TAVR in patients under 65 years presents a challenge for heart valve teams (HVTs) managing younger individuals whose life expectancy may surpass the durability of the valve. Patients over 65 years are typically treated with bioprosthetic tissue valves; however, there remains significant uncertainty regarding the selection between TAVR and SAVR.

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