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- Symptomatic aortic stenosis if left untreated has a high mortality rate (5 yr mortality rate is 50% w/angina, 3 yr mortality rate is 50% w/syncope, and 2 yr mortaltiy rate is 50% w/CHF)
- Standard tx includes medical therapy +/- balloon aortic valvuloplasty
- A recent study comparing standard therapy to transcatheter aortic-valve replacement (TAVR) revealed rates of death at 2 yrs were 68% in standard therapy group vs. 43.3% in TAVR group (p<0.001)
- At 2 yrs the rate of rehospitalization was 72.5% in standard therapy group vs. 35% in TAVR group
- The rate of stroke was higher after TAVR vs. standard therapy in the 1st 30 days
- In appropriate patients with severe AS who are not surgical candidates TAVR reduced rates of death, hospitalizations, and symptoms at 2 yr follow-up
References
Makkar R, Fontana G, et al. Transcatheter Aortic-Valve Replacement for Inoperable Severe Aortic Stenosis. NEJM. May 2012: 366; 18.