Transcatheter Aortic Valve Replacement (TAVR) continues to be one of the great success stories in healthcare, rapidly overtaking surgical aortic valve replacement as the treatment option of choice for a large number of patients who present with aortic stenosis. severe symptomatic. But what’s next for this rapidly evolving procedure? What trends should we watch over time?
To discover, Cardiovascular business spoke with an interventional cardiologist Samir Kapadia, MDdirector of the department of cardiovascular medicine at Cleveland Clinic. Read the conversation below:
When you think of the state of TAVR in 2023, what comes to mind? What TAVI-related trends should hospitals and healthcare systems focus on in the coming years?
Samir Kapadia: As far as the TAVR is concerned, progress is progressing at an exponential rate. The first TAVR valve was implanted in 2002 and became the standard of care in just 20 years.
And when you think about it, from the first valve that was replaced in the United States to any valve that is replaced today, every valve is monitored. Each TAVR patient is included in the Society of Thoracic Surgeons/American College of Cardiology TVT Registry, and data is stored and available for analysis for each patient. This is a very unique situation – no other technology or processing has this kind of data or has undertaken this kind of scientific journey.
A big change in TAVR is that more devices are available now than there were in the past, and even more devices are in the works. And what’s happened is that instead of focusing on the patient – their age, their comorbidities, their clinical situation – we now focus more on the anatomy. Anatomy is the main feature, the main reason we decide whether we will go for TAVR or surgery. The main deciding factor is no longer the patient’s comorbidities or whether the patient is high-risk or low-risk. Instead, we are now talking about anatomy. Is the anatomy such that TAVR will be a lifelong solution to the patient’s aortic stenosis?
In the coming years, we will focus more on the lifelong management of a patient’s aortic stenosis. If a patient is 60 years old and needs an aortic valve replacement, what is the best way to replace the valve and ensure that we do not regret this decision in the future? The last valve replacement a patient receives, when they are 80 or 90 years old, should be done using the TAVR. We will need a strategy that helps us achieve this goal and allows the patient to live a long, healthy life without aortic stenosis.