A 70-year-old man with severe symptomatic aortic stenosis (valve area 0.7 cm², mean gradient 52 mmHg) is referred for TAVI (TAVR). The PARTNER 3 and Evolut Low Risk trials demonstrated TAVR was non-inferior to surgical AVR for which patient population?
- A Intermediate surgical risk patients only
- B High surgical risk and inoperable patients only
- C Low surgical risk patients (STS score <4%) ✓
- D Any age patient with severe AS regardless of risk
Correct answer: C. Low surgical risk patients (STS score <4%)
Explanation
PARTNER 3 (balloon-expandable) and Evolut Low Risk (self-expanding) trials demonstrated TAVR was non-inferior (and in PARTNER 3, superior) to surgical AVR in low-risk patients (STS score <4%) with severe symptomatic AS. This expanded TAVR indications from high/extreme risk (PARTNER 1, CoreValve) to intermediate risk (PARTNER 2, SURTAVI) to low risk. Current ACC/AHA guidelines now recommend TAVR as reasonable for all ages and surgical risk levels with life expectancy >12 months.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.