Symptomatic aortic stenosis if left untreated has a high mortality rate (5 yr mortality rate is 50% w/angina, 3 yr mortality rate is 50% w/syncope, and 2 yr mortaltiy rate is 50% w/CHF)
Standard tx includes medical therapy +/- balloon aortic valvuloplasty
A recent study comparing standard therapy to transcatheter aortic-valve replacement (TAVR) revealed rates of death at 2 yrs were 68% in standard therapy group vs. 43.3% in TAVR group (p<0.001)
At 2 yrs the rate of rehospitalization was 72.5% in standard therapy group vs. 35% in TAVR group
The rate of stroke was higher after TAVR vs. standard therapy in the 1st 30 days
In appropriate patients with severe AS who are not surgical candidates TAVR reduced rates of death, hospitalizations, and symptoms at 2 yr follow-up
References
Makkar R, Fontana G, et al. Transcatheter Aortic-Valve Replacement for Inoperable Severe Aortic Stenosis. NEJM. May 2012: 366; 18.
