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Transcatheter Aortic Valve Replacement in Severe Aortic Stenosis: A Review of Comparative Durability and Clinical Effectiveness Beyond 12 Months [Internet].


Ho C, Cimon K, Rabb D.


Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2013 Apr.
CADTH Rapid Response Reports.


Transcatheter aortic valve replacement (TAVR), sometimes called transcatheter aortic valve implantation (TAVI), was developed as an alternative for patients with severe aortic stenosis, who require aortic valve replacement but who are not eligible for conventional surgical aortic valve replacement (SAVR). According to a 2011 report, approximately 300,000 people worldwide have been diagnosed with severe aortic stenosis and approximately one-third of them are considered too high risk for open heart surgery. Currently, the two most common approaches for TAVR are transfemoral and transapical procedures. There are two commercially available systems for TAVR: Edwards Sapien (LifeSciences, Irvine, CA, US) and CoreValve (Medtronic, Minneapolis, MN, US). The benefits of TAVR with up to one year follow-up were demonstrated in two randomized controlled trials (RCTs) — PARTNER cohorts A and B — which showed that TAVR has statistically significant clinical benefits compared with standard therapy or SAVR, as summarized in a previous Rapid Response review. With the aim to review long-term success and complication rates of the procedure, this report will provide a review of the use of TAVR at more than 12 months follow-up in patients with severe aortic stenosis, compared with SAVR or standard treatment (medical therapy plus balloon aortic valvuloplasty if needed).

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