2020 ACC/AHA Guideline emphasizes shared decision-making and recommends considering TAVR for symptomatic severe AS patients age 65–80

The ACC/AHA released key updates in their recent 2020 guideline for Valvular Heart Disease (VHD), including new guidance for the treatment of symptomatic severe aortic stenosis (SAS) and transcatheter aortic valve replacement (TAVR).

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TAVR more prominently featured in latest guidelines

When intervention is considered, patients should be evaluated by a Heart Team (Class 1C-EO)

Engagement between the Heart Team and the primary clinical cardiologist is of critical importance

Recommendations for intervention now focus on age and shared decision-making

For symptomatic SAS patients 65 to 80 years old, TAVR should be considered, based on shared decision-making

"All patients with severe valvular heart disease being considered for valve intervention should be evaluated by a multidisciplinary team..."1

2020 ACC/AHA Guideline, Top 10 Take-Home Messages

Evaluations should be multidisciplinary and multi-institutional, with those in essential roles working together and leveraging consultative and supportive roles when needed

TAVR is an effective approach to aortic valve replacement.

2020 ACC/AHA Guideline on intervention recommendations by age1

For symptomatic patients with severe AS and no anatomic contraindication to transfemoral TAVR

Indications for TAVR are expanding as a result of multiple randomized trials, including the latest PARTNER trials, which are reflected in these recommendations

Key factors for considering valve intervention for Symptomatic SAS patients have changed

The Guideline recognizes the benefits associated with TAVR*, independent of surgical risk

Shorter hospital stay

Lower risk of transient or permanent AF

More rapid return to normal activities

Lower risk of major bleed and pain

*When compared to SAVR. SAVR is associated with a lower risk of paravalvular leak, less need for valve reintervention, and permanent pacemaker.

Consider even more patients for a TAVR evaluation. View the 2020 ACC/AHA Guideline Pocket Guide for up-to-date information.

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References:   1. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2020. Epublished DOI: 10.1016/j.jacc.2020.11.018.