TAVR versus SAVR no tratamento da Estenose Aórtica Severa em doentes com risco cirúrgico inferior a alto - uma revisão narrativa

Abstract

Aortic stenosis is the primary valve disease that most often leads to valve replacement. This pathology essentially affects older patients, so the correct stratification of disease's severity and patient's surgical risk assumes a predominant role in the best intervention choice. In patients with severe aortic stenosis who are not candidates for surgical intervention or are at high surgical risk, Transcatheter Aortic Valve Replacement (TAVR) is defined as first line treatment. For lower surgical risks, although the AHA / ACC guideline considers this technique non-inferior to Surgical Aortic Valve Replacement (SAVR), TAVR is not yet indicated as a viable alternative to SAVR in other international guidelines. According to the main studies related to the technique, TAVR is a less invasive procedure and has non-inferior or even superior results to SAVR regarding outcomes such as mortality rate and stroke risk. In addition, the complications most often associated with this technique are probably consequence of not expanding its indications, resulting in low physician's experience.