From the 1980s through the early 2000s, aortic balloon valvuloplasty was the sole nonsurgical intervention for severe AS. However, this procedure is associated with high restenosis rates (often within weeks or months), and no survival benefit. Its current indications include bridge to TAVR in acutely symptomatic or unstable patients, and symptom palliation in patients who are not TAVR candidates.

By contrast, TAVR has rapidly become the most common treatment for AV stenosis in the United States. It is recommended over surgical AV replacement for patients with severe AS over the age of 80 years, and is increasingly utilized in younger and lower-risk patient groups. Two types of valves are currently U.S. Food and Drug Administration (FDA)-approved and available on the US market: balloon-expandable SAPIEN valves (Edwards Lifesciences Corporation) and self-expandable CoreValves (Medtronic). Additional valve models and manufacturers are approved for use in Europe and elsewhere.

References

• Boskovski MT, Gleason TG. Current therapeutic options in aortic stenosis. Circ Res. 2021;128:1398-1417.