New Best Practice Protocol - Lifetime Management of Aortic Stenosis

With the approval of low risk transcatheter aortic valve replacement, a shift to lifetime management has now gained focus. This is because younger and healthier patient populations are more likely to outlive their first surgical or transcatheter bioprosthetic aortic valve.

The Aortic Valve Lifetime Management Best Practice Protocol covers multiple considerations for heart teams and patients as they engage in shared decision making.

These include:

  • The mechanism of aortic stenosis
  • The presence of concomitant coronary artery
    disease and other pathologies
  • Individual patient anatomy and suitability for both surgical and or transcatheter approaches.

The protocol covers guidelines for aortic valve replacement including current trends in SAVR and TAVR, British and U.S. data, and experiences from MISHC.

SAVR-FIRST and TAVR-first CONSIDERATIONS are outlined, as are unknowns including valve durability and valve differences. MISHC Best Practice Protocols are based on consortium-wide consensus at the time of publication. You can view the complete protocol on mishc.org under “Quality Improvement” and “Best Practices.”