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A joint PCR and CRF statement on lifetime management of aortic stenosis: key considerations before, during and after the index procedure

Cardiovascular Surgery

Paris, France, 16 May 2023. Within 20 years of its first appearance on the clinical stage transfemoral transcatheter aortic valve implantation (TF-TAVI) has become an established treatment option for patients with symptomatic severe aortic stenosis (AS) that is supported by Class IA recommendations in current European and US guidelines on the management of valvular heart disease. Technological innovations and procedural refinements have made TAVI a safe and streamlined intervention, while accumulating long-term follow-up data suggest that durability will be comparable to surgical aortic bioprostheses.

In daily practice, Heart Teams may choose TAVI as an initial treatment option for patients with prolonged life expectancy (>10 years). This requires higher standards regarding the index TAVI procedure planning and execution, aiming at minimising potential complications (paravalvular regurgitation, mismatch, pace-maker implantation) and keeping an easy access to the coronary arteries. But with the expectation that many of those patients will require a second valve intervention, being older at the time of this reintervention, a second percutaneous procedure seems likely. However, implanting a second transcatheter heart valve (THV) may be a complex and difficult procedure depending on the baseline anatomy and technical choices made at the time of initial transcatheter valve implantation. Equally, surgical explantation of a degenerated THV device may be more complex than a simple surgical aortic valve replacement. Careful advance planning is therefore essential when contemplating the prospect of TAVI in younger patients and the Heart Team needs to consider these issues carefully when conceiving an overall lifetime treatment strategy. Further randomised clinical trials comparing surgery and different TAVI therapies will be indicated in the future for this problematic younger patient population who will likely require multiple sequential procedures during their life history with AS.

This topic will come under the spotlight in a Main Arena “Partners in Learning” session prepared by EuroPCR in collaboration with TCT on Tuesday, 16 May from 12:00 -13:30. The programme, which incorporates a live case from Toulouse, will encompass the latest clinical evidence governing the application of TAVI in the lifetime journey of younger patients with AS, identify clinical and anatomical factors that determine the choice between TAVI and surgical aortic valve replacement, and demonstrate how valve design, implantation technique and in-depth anatomical analysis can influence long term outcomes and future treatment options after the index TAVI procedure. Don’t miss it!


Notes to editor

Key information
• Session: Lifetime management of aortic stenosis - Key considerations before, during and after the index procedure: LIVE Case from Clinique Pasteur, Toulouse – France
• Palais des Congrès Porte Maillot – Paris, France
• Tuesday 16 May 2023 - 12:00 - 13:30 - Main Arena

About EuroPCR 2023
The World-Leading Course in interventional cardiovascular medicine and the official annual meeting of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) will take place from 16 to 19 May 2023, onsite at the Palais des congrès, Paris, France. A digital package is also available for those unable to join in person. The detailed Course Programme is available on:

About PCR
The mission of PCR is to serve the needs of each individual patient by helping the cardiovascular community to share knowledge, experience and practice. PCR offers a large range of many other educational meetings and resources for the continuing education of the interventional cardiovascular community. These include major annual Courses across the globe, e-Learning with high-profile PCR Webinars, Courses specifically dedicated to valvular heart disease, tailor-made PCR Seminars on specific topics, online resources and medical publications such as EuroIntervention, the official journal of the EAPCI.
Gateways to all PCR activities are available on
For further information, please contact Sally Collingridge:

About the EAPCI
The European Association of Percutaneous Cardiovascular Interventions (EAPCI) is a branch of the European Society of Cardiology. Its mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions. This dynamic association represents a community of over 8,700 healthcare professionals by helping them remain up to date in the constantly evolving field of PCI by publishing research and providing training and certification programmes. The EAPCI also advocates for the best possible access to life saving treatments for patients through data-based advocacy at a European level.

About CRF
The Cardiovascular Research Foundation helps doctors improve survival and quality of life for people suffering from heart and vascular disease and was established to defy heart disease. The Cardiovascular Research Foundation works to identify, develop and promote the latest advancements in the treatment of heart and vascular disease. By covering all aspects of the research continuum, it is able to accelerate the speed with which breakthrough therapies reach patients through doctors, improving survival rates and quality of life, faster.