Transcatheter Valve Replacement for Aortic Stenosis: Balancing Benefits, Risks, and Expectations

Transcatheter Aortic valve replacement (TAVR) represents a transformative technology with potential for the management of complex patients with aortic stenosis, including those who are not considered candidates for surgical aortic valve replacement because of age and medical comorbidities. Currently, more than 50,000 TAVR procedures have been performed worldwide, with mounting enthusiasm for the "rational dispersion" of transcatheter therapies. The US Food and Drug Administration recently approved TAVR as a reasonable alternative to surgical aortic valve replacement in high-risk patients with aortic stenosis. The increasing consumer expectations that this therapy might become available soon for even young, low-risk patients requiring valve replacement must be balanced against safety concerns that have arisen in both clinical trials and registries. Here, Desai and Bonow look at the benefits, risks, and expectations of transcatheter valve replacement for aortic stenosis.