TAVR in Young Patients With Aortic Stenosis

American College of Cardiology/American Heart Association guideline recommendations for transcatheter aortic valve replacement (TAVR) transitioned in 2020 from decision-making based on estimated risk of surgical valve replacement (SAVR) to one based on patient age and expected longevity. Trial data support TAVR in elderly patients (age >80 years) and TAVR or SAVR in those aged 65 to 80 years, based on multidisciplinary heart team assessment and shared decision-making. In younger patients (<65 years), SAVR is recommended, as very few patients in this age group were enrolled in the randomized trials with additional concerns regarding transcatheter valve durability and higher rates of pacemaker implantation with TAVR.