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SAVR vs. TAVR: How to Decide?

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Harvard Medical School Continuing Education

This Harvard Medical School Continuing Education video examines the key question: what do the 2020 ACC/AHA Valvular Heart Disease Guidelines have to say about surgical aortic valve replacement versus transcatheter aortic valve replacement?

Dr. Evin Yucel, MD, FACC, a cardiologist with Massachusetts General Hospital, explains the differences between surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) while reviewing the indications for and outcomes of each procedure. Antithrombotic therapy after aortic valve replacement is discussed and findings from the GALILEO trial are highlighted.

This video was peer reviewed by Dr. Jonathan Salik, TMD, MHPEd, Instructor of Medicine, Massachusetts General Hospital; and Dr. Sugantha Sundar, MD, Assistant Professor of Anesthesia, Beth Israel Deaconess Medical Center, to validate the quality and accuracy of the content. It was edited by affiliate physicians of Harvard Medical School, Avanthi Raghavan, MD Cardiology Fellow, Massachusetts General Hospital and Anna Handorf, MD, Research Fellow in Pediatrics, Massachusetts General Hospital.

00:00 | Introduction
00:55 | Indications for SAVR vs TAVR
03:40 | TAVR in patients with bicuspid aortic valve stenosis
04:38 | Antithrombotic therapy following atrioventricular replacement

References:
Siontis GCM, Overtchouk P, Cahill TJ, et al. Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: an updated metaanalysis. Eur Heart J. 2019;40(38):31433153. doi:10.1093/eurheartj/ehz275 

Makkar RR, Yoon SH, Leon MB, et al. Association Between Transcatheter Aortic Valve Replacement for Bicuspid vs Tricuspid Aortic Stenosis and Mortality or Stroke. JAMA. 2019;321(22):21932202. doi:10.1001/jama.2019.7108 

Dangas GD, Tijssen JGP, Wöhrle J, et al. A Controlled Trial of Rivaroxaban after Transcatheter AorticValve Replacement. N Engl J Med. 2020;382(2):120129. doi:10.1056/NEJMoa1911425 

Notice: At this time, the content in this video is not accredited.

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