Patient evaluation and selection for transcatheter aortic valve replacement: the heart team approach.
Transcatheter aortic valve replacement (TAVR) has been shown to significantly impact mortality and quality of life in patients with severe aortic stenosis (AS) who are deemed high risk for surgical aortic valve replacement (SAVR). Essential to these outcomes is proper patient selection. The multidisciplinary TAVR heart team was created to provide comprehensive patient evaluation and aid in proper selection. This review with outline the history and components of the heart team, and delineate the team's role in risk and frailty assessment, evaluation of common co-morbidities that impact outcomes, and the complex multi-modality imaging necessary for procedural planning and patient selection. The heart team is critical in determining patient eligibility and benefit and the optimal operative approach for TAVR. The future of structural heart disease will certainly require a team approach, and the TAVR heart team will serve as the successful model.
Division of Cardiology, Barnes Jewish Hospital, Washington University School of Medicine, St Louis, MO.
Marc
M
Sintek
Division of Cardiology, Barnes Jewish Hospital, Washington University School of Medicine, St Louis, MO. Electronic address: azajaria@dom.wustl.edu.
Alan
A
Zajarias
D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects; D003661:Decision Support Techniques; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D064847:Multimodal Imaging / Q000379:methods; D010348:Patient Care Team; D018579:Patient Selection; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
Heart team; Patient eligibility; Patient selection; Transcatheter aortic valve replacement