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Reading: Is TAVR Ready for the Global Aging Population?

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Is TAVR Ready for the Global Aging Population?

Authors:

Travis Bergmann,

Cardiac Ultrasound Research and Core Lab, Department of Medicine, Mount Sinai's Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, New York, NY, US
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Partho P. Sengupta ,

Cardiac Ultrasound Research and Core Lab, Department of Medicine, Mount Sinai's Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, New York, NY, US
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Jagat Narula

Cardiac Ultrasound Research and Core Lab, Department of Medicine, Mount Sinai's Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, New York, NY, US
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Abstract

The emergence of the global pandemic of chronic diseases necessitates critical assessment of interventions that can be targeted at both the individual and population levels. Among cardiovascular diseases, the increasing prevalence of valvular heart diseases such as aortic stenosis parallels the rising burden of atherosclerotic cardiovascular diseases. As an alternative to surgical aortic valve replacement, technological innovation has allowed development of minimally invasive transcatheter aortic valve replacement (TAVR). This review examines whether TAVR can be applicable in low-resource regions across the world. Although revolutionary, TAVR is currently complex and requires a “Heart Team” approach for optimized patient care. We propose the emergence of telemedicine networks, newer valve designs that allow implementation of minimal approaches, and the use of minimal numbers of specialists for adapting TAVR to settings where surgical backup is not available. With efforts to reduce resource utilization, these alternate strategies have the potential to affect implementation of TAVR globally.

Highlights

  • Globally aging populations are associated with an increased burden of AS.
  • Disparities exist globally in the utilization and development of AS interventions such as TAVR.
  • Barriers to TAVR implementation include lack of surgeons, poor clinic standards, and training.
  • Potential solutions include use of telemedicine, minimalist techniques, and minimizing the heart team.
How to Cite: Bergmann T, Sengupta PP, Narula J. Is TAVR Ready for the Global Aging Population?. Global Heart. 2017;12(4):291–9. DOI: http://doi.org/10.1016/j.gheart.2017.02.002
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Published on 01 Dec 2017.
Peer Reviewed

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