Table 3.18-4. Factors influencing transcatheter versus surgical valve replacement for aortic stenosis

Factors favoring TAVR

Factors favoring SAVR

– Isolated symptomatic severe aortic stenosis with acceptable aortic and vascular anatomy for transcatheter replacement

– Noncardiac comorbidities that increase operative risks and reduce ability to recover from sternotomy

– Young patients benefiting from durability of mechanical valves

– Multilevel obstruction (eg, involving left ventricular outflow tract)

– Surgical intervention required for coronary disease, aortopathy, nonaortic valve disease, or endocarditis

– Presence of left ventricular thrombus

– Inadequate vascular access (vessel size, calcification, tortuosity) or factors that increase technical difficulty of TAVR

SAVR, surgical aortic valve replacement; TAVR, transcatheter aortic valve replacement.