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Diagnosis and Prognosis of Coronary Artery Disease with SPECT and PET Everolimus-Eluting Bioresorbable Scaffolds Versus Everolimus-Eluting Metallic Stents Nonculprit Lesion Myocardial Infarction Following Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes Anatomical plaque and vessel characteristics are associated with hemodynamic indices including fractional flow reserve and coronary flow reserve: A prospective exploratory intravascular ultrasound analysis Optical coherence tomography findings: insights from the “randomised multicentre trial investigating angiographic outcomes of hybrid sirolimus-eluting stents with biodegradable polymer compared with everolimus-eluting stents with durable polymer in chronic total occlusions” (PRISON IV) trial Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients Prognostic Implication of Thermodilution Coronary Flow Reserve in Patients Undergoing Fractional Flow Reserve Measurement Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review Incidence and prognostic implication of unrecognized myocardial scar characterized by cardiac magnetic resonance in diabetic patients without clinical evidence of myocardial infarction
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GuidelineJuly 21, 2021

JOURNAL：JAMA Cardiol. Article Link

Guideline Update on Indications for Transcatheter Aortic Valve Implantation Based on the 2020 American College of Cardiology/American Heart Association Guidelines for Management of Valvular Heart Disease

TM Sundt; H Jneid et al. Keywords: TAVR; valular heart disease; indication; guideline

ABSTRACT

The continued evolution of transcatheter aortic valve implantation (TAVI) technology and the results of multiple randomized clinical trials (RCTs) have firmly established this approach as an alternative to surgical aortic valve replacement (SAVR) in the treatment of aortic stenosis in all risk groups. Deciding on TAVI or SAVR depends on patient-specific factors, including technical, procedure-specific contraindications and the balance between estimated life expectancy and anticipated prosthesis durability. These factors pertain to the decision between mechanical and biological prostheses, and if the choice is biological, between SAVR and TAVI. A strong emphasis is now placed on shared decision-making with the patient and involvement of the multidisciplinary heart team. For most patients younger than 65 years, SAVR is recommended, with mechanical valves favored in those younger than 50 years. For those older than 65 years, the perioperative risks of mortality and stroke are lower with transfemoral TAVI compared with SAVR, but the risks of paravalvular leak, a pacemaker requirement, and vascular complications are higher.
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