Growing demand for a minimally invasive aortic valve replacement by adults under 65 with aortic stenosis may put many at greater risk for potentially more complicated heart surgeries later, according to a University of Rochester Medicine study published in The Annals of Thoracic Surgery.
Scientists recommend patients work with a multidisciplinary heart care team to assess their short- and long-term needs when facing surgery.
The procedure, transcatheter aortic valve replacement (TAVR), is less invasive than open-heart surgery, offering a faster recovery. Since its introduction in 2011, TAVR is the recommended alternative for frail adults over 65 who cannot withstand surgical aortic valve replacement (SAVR) and younger adults whose mortality risk is high.
However, analysis of the Vizient Clinical Database of nearly 14,000 aortic stenosis cases between 2018 and 2023 showed nearly half of the lowest risk patients under 65 underwent TAVR despite the recommendation that they undergo SAVR. And SAVR can be performed using less invasive techniques that can reduce recovery times.
"It's not surprising that people want a 'quick fix' that lets them get back to their normal routine. However, TAVR is not without risks," said Laurent G. Glance, MD, lead author and professor of Anesthesiology and Perioperative Medicine. "The bioprosthetic valve can wear out or leak and lead to additional complicated surgeries later."
