Chapter 34 - Transcatheter aortic valve failure: the impact of calcification

Abstract

Transcatheter aortic valve replacement (TAVR) has become the standard of care for high-risk and inoperable surgical patients and a valid alternative to surgery for low- and intermediate-risk patients with severe, symptomatic aortic stenosis. Several clinical studies have demonstrated similar clinical outcomes between TAVR and surgical aortic valve replacement. With the expansion of TAVR indication to younger, lower-risk patients, data on long-term durability are essential. However, long-term data are limited because TAVR is a relatively young technology. In lieu of such data, autopsy studies, case reports, and clinical trials all suggest low rates of transcatheter aortic valve degeneration with comparable or better durability than surgically implanted aortic valves. In this chapter, we summarize the pathological findings of TAVR valves, report the impact of calcification on the procedure, and compare these results to those of surgically implanted aortic bioprosthetic valves.