The Low-Risk Patient
The Low-Risk Patient
The Low-Risk Patient
The Low-Risk Patient
Unprecedented outcomes for low-risk symptomatic severe aortic stenosis (sSAS) patients with TAVR
Now your low-risk patients have a chance for excellent outcomes with Edwards SAPIEN 3 transcatheter aortic valve replacement. In the past, transcatheter aortic valve replacement was recommended only for high- and intermediate-risk patients, who account for only 2 out of 10 patients. Thus, about 80% of patients received open-heart surgery. But now, you no longer have to reserve the less-invasive option for your sickest patients*.
Get the Low-Risk Outcomes Guide*The PARTNER 3 Trial, SAPIEN 3 Transcatheter Aortic Valve Replacement proven superior to surgery on the primary endpoint of all-cause death, all stroke, and rehospitalization (valve-related or procedure-related and including heart failure) at one year, and multiple pre-specified secondary endpoints in low risk patients.
PARTNER 3 Trial 5-Year Results in Low-Risk Patients - Low rates of cardiovascular mortality through five years (5.5% SAPIEN 3 Transcatheter Aortic Valve Replacement to 5.1% SAVR). Low rates of all-cause mortality through five years (10.0% SAPIEN 3 Transcatheter Aortic Valve Replacement vs. 8.2% with SAVR). Low rates of disabling stroke through five years (2.9% SAPIEN 3 Transcatheter Aortic Valve Replacement to 2.7% SAVR). Low rates of stroke through five years (5.85% SAPIEN 3 Transcatheter Aortic Valve Replacement vs. 6.4% SAVR). Lower rates of rehospitalization with SAPIEN 3 Transcatheter Aortic Valve Replacement through five years (13.7% vs. 17.4%).
You have the power to give your patients a chance at excellent outcomes by guiding them to a TAVR evaluation
Low-risk sSAS patients are a unique population, with fewer comorbidities (COPD, CAD, and pacemaker) and a mean age 10 years younger than those studied in previous PARTNER trials1-3.
Do you know what the 2020 ACC/AHA Guideline says about TAVR for low-risk sSAS patients?
Edwards Lifesciences has developed a quick assessment to help you further your understanding of the 2020 ACC/AHA Guideline and support your low-risk patients' treatment pathway.
1. According to the 2020 ACC/AHA guideline what is the hemodynamic definition of Stage D2 - symptomatic severe low-flow, low-gradient aortic stenosis (AS) with reduced LVEF?
A
Aortic Valve Area ≤ 1.0 cm2 and Aortic Jet Velocity < 4 m/s or Mean Gradient < 40 mm HG
B
Aortic Valve Area ≤ 0.8 cm2 and Aortic Jet Velocity < 4 m/s or Mean Gradient ≥ 40 mm HG
C
Aortic Valve Area ≤ 1.0 cm2 and Aortic Jet Velocity < 4 m/s or Mean Gradient ≥ 40 mm HG
D
Aortic Valve Area ≤ 0.7 cm2 and Aortic Jet Velocity < 2.5 m/s or Mean Gradient ≥ 40 mm HG
Question 1/8
2. Which age range should patients with symptomatic severe aortic stenosis (Stage D1) be recommended for SAVR?
A
Under 75
B
Under 65
C
Under 60
D
Under 70
Question 2/8
3. According to the 2020 ACC/AHA guideline when should asymptomatic severe aortic stenosis (Stage C1) be followed-up on with Echocardiography?
A
12-24 months
B
1-3 months
C
12-18 months
D
6-12 months
Question 3/8
4. According to the 2020 ACC/AHA guideline what is the hemodynamic definition of severe aortic stenosis (Stage C - asymptomatic aortic stenosis)?
A
Aortic Jet Velocity > 4 m/s or Mean Gradient ≤ 35 HG and Aortic Valve Area ≥ 1.0 cm2
B
Aortic Jet Velocity < 4 m/s or Mean Gradient ≥ 40 HG and Aortic Valve Area ≥ 0.8 cm2
C
Aortic Jet Velocity < 4 m/s or Mean Gradient ≥ 35 HG and Aortic Valve Area ≥ 0.6 cm2
D
Aortic Jet Velocity > 4 m/s or Mean Gradient ≥ 40 HG and Aortic Valve Area ≤ 1.0 cm2
Question 4/8
5. What diagnostic test can assist in diagnosing low-flow, low-gradient symptomatic severe aortic stenosis?
A
CT Imaging
B
Stress Test
C
TTE Imaging
D
Dobutamine Stress Test
Question 5/8
6. Which age range should patients with symptomatic severe aortic stenosis (Stage D1) be considered for either TAVR or SAVR?
A
Between 60-85 years old
B
Between 65-80 years old
C
Between 75-80 years old
D
Between 70-80 years old
Question 6/8
7. What age range is TAVR recommended in preference to SAVR for Stage D aortic stenosis?
A
Above 80 years old
B
Above 82 years old
C
Above 85 years old
D
Above 75 years old
Question 7/8
8. What are the three factors that favor TAVR to SAVR for aortic valve replacement in the ACC/AHA guideline?
A
Aortic dilation, severe calcification of the ascending aorta, severe renal disease
B
Severe primary mitral regurgitation, mobility issues of patient, longer durability
C
Severe CAD, mobility issues of patient, previous chest irradiation
D
Shorter length of stay, mobility issues of patient, previous cardiac operations with at-risk coronary graft
Question 8/8
Recommended resources
See all resourcesReferences: 1. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019;380(18):1695-1705. 2. Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374(17):1609-1620. 3. Leon MB, Smith CR, Mack MJ, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597-1607. 4. Mack MJ, Leon MB, Thourani P, Transcatheter aortic valve replacement in low-risk patients at five years. N Engl J Med. 2023;10.1056/NEJMoa2307447.