TAVI Guideline Update from the AHA/ACC

Transcatheter aortic valve implantation (TAVI) is now included in the valvular heart disease guidelines from the American Heart Association and American College of Cardiology.

This AHA/ACC update is the first on the management of valvular heart diseases since 2008, and focuses on the implementation of TAVI and the treatment options for patients with severe aortic stenosis.  

In patients with indication for aortic valve replacement but with high surgical risk, the guidelines say that TAVI is a reasonable alternative to surgery.

A 4 category classification system—at risk, progressive, asymptomatic severe, and symptomatic severe—will be used to rank patients with valve disease.

The guidelines also include a risk assessment tool for patients being considered for intervention. Furthermore, it lowers the standard for which patients, including those that are asymptomatic, should be considered for intervention.

“As valve repair and replacement options improve, the balance will shift toward earlier intervention,” the authors concluded.

“Transcatheter valve procedures offer the promise of safe implantation and excellent hemodynamics, but long-term durability is not yet known.”

–Michael Potts

Reference

Nishimura RA, Otto CM, Bonow RO, Carabello BA, et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease. [published online ahead of print] Journal of the American College of Cardiology. doi: 10.1016/j.jacc.2014.02.536.