Updates in Using TAVR for Treating Aortic Stenosis, with Linda Gillam, MD, MPH

Since the turn of the century, the field of cardiology has found itself as the beneficiary of a multitude of scientific breakthroughs and advances in disease management across a wide spectrum of cardiovascular diseases, including valvular heart disease, with new approaches such transcatheter aortic valve replacement (TAVR) marking a historic shift in management approach for many patients.

First approved in 2011 for severe aortic stenosis in older patients with prohibitive risk, use of TAVR has ballooned in recent years, with guidelines from major endorsements now recognizing a role for TAVR in patients aged 65 years and older deemed low to moderate risk.

For perspective on the latest updates in management of severe aortic stenosis, the editorial team of HCPLive Cardiology sat down with Linda Gillam, MD, MPH, chair of Cardiovascular Medicine at Morristown Medical Center, medical director of the Cardiovascular Service Line for Atlantic Health System and professor of Medicine at Thomas Jefferson University. A leading subject matter expert, Gillam served as a chairperson during a Hot Line session at the European Society of Cardiology 2024 Congress and presented on the role of imaging and biomarkers at Baptist Health’s Echocardiography and Structural Heart Symposium in September 2024.

In the interview, Gillam discussed several challenges and advancements in the treatment of aortic stenosis, particularly in cases of low-gradient stenosis. Gillam highlights challenges in identifying patients with severe, hemodynamically significant aortic stenosis, who benefit more from treatment than from medical management alone. Later, she draws attention to the role advancements in imaging and biomarkers, such as echocardiography and cardiac MRI, play in refining treatment strategies, which have allowed clinicians to assess heart function and valve damage more precisely.

For more from that conversation, check out the video below.

Relevant disclosures for Gillam include Medtronic, Edwards Lifesciences, Boehringer Ingelheim, and Novartis.

References:

1. Mahmaljy H, Tawney A, Young M. Transcatheter aortic valve replacement. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; January 2024. Updated July 24, 2023.
2. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [published correction appears in Circulation. 2021 Feb 2;143(5):e229. doi: 10.1161/CIR.0000000000000955] [published correction appears in Circulation. 2023 Aug 22;148(8):e8. doi: 10.1161/CIR.0000000000001177] [published correction appears in Circulation. 2023 Nov 14;148(20):e185. doi: 10.1161/CIR.0000000000001190] [published correction appears in Circulation. 2024 Sep 17;150(12):e267. doi: 10.1161/CIR.0000000000001284]. Circulation. 2021;143(5):e72-e227. doi:10.1161/CIR.0000000000000923