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Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2026, Number 2

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Cir Card Mex 2026; 11 (2)

When expansion outpaces certainty: Transcatheter Aortic Valve Replacement in patients younger than 65 years

García-Villarreal OA

Language: English
References: 5
Page: 43-44
PDF size: 464.38 Kb.


Text Extraction

The contemporary evolution of Transcatheter Aortic Valve Replacement (TAVR) into progressively younger populations represents one of the most consequential shifts in structural heart disease over the past decade. In their national analysis from the STS/ACC TVT Registry, Alabbadi et al. document not merely an epidemiologic trend, but a conceptual transformation in the management of patients younger than 65 years with aortic stenosis.
TAVR was originally reserved for individuals at prohibitive or extreme surgical risk. Following regulatory expansion by the U.S. Food and Drug Administration (FDA) in 2019,2 TAVR entered the low-risk arena, supported by pivotal randomized trials such as PARTNER 33 and Evolut Low Risk.4 These studies demonstrated non-inferiority, and in some cases, superiority,


REFERENCES

  1. Alabbadi S, Stebbins A, Vemulapalli S, et al. Trends in case mix andoutcomes after transcatheter aortic valve replacement in patientsyounger than 65 years: insights from the STS/ACC TVT Registry.J Am Coll Cardiol. 2026: S0735-1097(26)00072-0. doi: 10.1016/j.jacc.2026.01.011.

  2. FDA expands TAVR indication to low-risk patients [Internet].American College of Cardiology. [cited 2026 Mar 4]. Availablein: https://www.acc.org/Membership/Sections-and-Councils/Interventional-Section/Section-Updates/2019/08/19/08/16/FDAExpands-TAVR-Indication-to-Low-Risk-Patients

  3. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valvereplacement with a balloon-expandable valve in low-risk patients. NEngl J Med. 2019;380(18):1695-1705. doi: 10.1056/NEJMoa1814052.

  4. Popma JJ, Deeb GM, Yakubov SJ, et al. Transcatheter aortic-valvereplacement with a self-expanding valve in low-risk patients. N Engl JMed. 2019;380(18):1706-1715. doi: 10.1056/NEJMoa1816885.

  5. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHAGuideline for the Management of Patients with valvular heartdisease: executive summary: a report of the American College ofCardiology/American Heart Association Joint Committee on ClinicalPractice Guidelines. Circulation. 2021;143(5):e35-e71. doi: 10.1161/CIR.0000000000000932.




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