From the April 2022 issue of HealthCare Business News magazine


HCB News: Do you have a sense of how TAVR might be different in another 10 years or so?
MS: I think we've already started to see that TAVR has now supplanted surgery as the default option for patients with aortic stenosis, certainly for those over the age of 65. I think we'll continue to see increases, and what we'll be very excited to see is whether the TAVR valves have the same durability as the surgical valves, and that's something we're waiting on.

As we go forward, we may see valves that are slightly smaller, so they may continue to decrease the size of the delivery system. They may start to try to devise ways to make the TAVR valves more durable, whether that includes different materials or coating the leaflets with different material.
One of the one of the things that they've done so well is try to reduce the leaks around the TAVR device. Will there be changes to what we call lifetime management for younger patients? Will they make the devices so that the coronary access is more amenable in devices that have larger cells within them, so that you can get to the coronary arteries all the time? Those are the kinds of questions that are coming up.

HCB News: Are there other key considerations for providers to look at before adopting TAVR?
MS: Yeah, that goes with the durability issue. And the question is, are TAVR valves as durable as surgical and surgically-implanted valves? There's no reason to think they wouldn't be. They're made of the same materials, with similar design. But TAVR valves have to be crimped and then expanded in place in the aorta, so there's a question of whether that process might decrease durability. What we're waiting for is, honestly, data to say that TAVR valves are as durable or even more durable than surgical valves. Depending on their durability, that will shape how we treat these younger patients. I think it's easy to say for a patient 70 and older that putting in a TAVR valve is the right thing because [they] last between 10 and 15 years. Patients at age 65 will certainly have another valve procedure in their future.

HCB News: What resources are available to medical professionals interested in learning more about the procedure?
MS: There's lots of information available online from both Medtronic and Edwards Lifesciences providing information about the TAVR procedures in general. As you might expect, there's lots of information in the literature that can be easily looked up on websites like PubMed or Google Scholar, etc., where people can get a lot more information about the evidence behind using TAVR. There's information on many hospital's websites, like our website, and certainly information from the American College of Cardiology and the American Heart Association on these procedures. There are also educational courses given, as well as webinars.

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