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ACCF/AATS/SCAI/STS release consensus document to help guide use of minimally invasive heart therapy
Date:1/31/2012

treating valve disorders; this includes use of proctors as needed to serve on the heart care team during the first few cases, as well as proper facilities (hybrid operating rooms or modified cath labs)
  • TAVR screening tests to inform treatment decisions
  • Enhanced patient and family education in the risk and benefits of this procedure
  • Ongoing evaluation and participation in national TAVR registry to assess real world outcomes

    An estimated 45,000 patients have received TAVR worldwide. Multiple single and multicenter registries, and a single randomized trial, have documented favorable outcomes using a wide spectrum of endpoints including survival, symptom status, quality of life, and need for repeat hospitalization. Clinical use of TAVR, its continued evolution, and outcomes will be evaluated in the new STS/ACC TVT registry which will further inform future recommendations on application of this transformational technology.

    "We have tried to collate the evidence into a coherent road map for judicious use, rational dispersion, and careful post-marketing scrutiny of this promising technology," said Sanjay Kaul, MD, a cardiologist at Cedars-Sinai Heart Institute in Los Angeles and vice chair of the writing committee. It is now the collective responsibility of all the stakeholders to optimize its full potential for improving the duration as well as the quality of survival in patients with severe symptomatic aortic valvular stenosis."

    While this technology has the potential to benefit many patients with AS, authors caution it is not for everyone and stress that more data is needed to ascertain the risk-benefit ratio prior to using this approach in certain groups. At present, and as outlined in the consensus document, TAVR is not recommended in adults who have:

    • An acceptable surgical risk for conventional surgical AVR
    • Known bicuspid aortic valve
    • Severe mitral annular calcification or severe MR
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    Contact: Amanda Jekowsky
    ajekowsk@acc.org
    202-375-6645
    American College of Cardiology
    Source:Eurekalert

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