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When calcific aortic stenosis is associated with symptoms, particularly congestive heart failure, it is also associated with a risk of death when not corrected surgically. Unfortunately, the frequency of the disease increases with age and patients who are most likely to have it are those who are at highest risk for open cardiac surgery. Transcatheter aortic valve replacement (TAVR) is an emerging treatment that is considerably less invasive than surgical aortic valve replacement (SAVR). The PARTNER investigators compared TAVR to conservative medical therapy in patients who were not candidates for SAVR (Kapadia and colleagues) and compared TAVR to SAVR in patients who were at high risk for SAVR (Mack and colleagues).
Two studies were performed as part of the PARTNER programme. Inclusion criteria were identical with the exception of perceived surgical risk. In Kapadia and colleagues study, two cardiovascular surgeons and an interventional cardiologist had to agree that …
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