Podcasts about Aortic stenosis

Welcome to the latest Midlife Minute. This episode unpacks ongoing research on Lp(a), explores how women's lipids change during the perimenopause-to-menopause transition, and clarifies what we can do about it. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: How total cholesterol, LDL, and ApoB tend to rise most steeply around the final menstrual period, rather than increasing gradually with chronological aging Why women should have their Lp(a) checked both before and after menopause How oral and transdermal estradiol can affect LDL, HDL, triglycerides, and Lp(a) differently Why I recommend including ApoB when checking your lipids during the perimenopause window How your lifestyle can reduce your cardiovascular risk, even when your Lp(a) is elevated Why omega-3 fatty acids and commonly used lipid medications do not lower Lp(a) Why supplements are not replacements for statins in genuinely high-risk patients  I review the various PCSK9 inhibitors currently available, how they are administered, and their effects  How a CAC, a CT angiogram, and an AI-assisted CT angiogram can help women and their providers determine how aggressive their approach should be when Lp(a) is elevated Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line References: 1. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association.Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.Guideline 2. Menopause: A Cardiometabolic Transition. The Lancet. Diabetes & Endocrinology. 2022. Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T.Review 3. Dyslipidemia Across the Menopause Transition: Mechanisms, Trajectories, and Opportunities for Cardiovascular Prevention. Maturitas. 2026. Castaneda R, Tatit CP, Hurtado Andrade MD, Faubion SS, Shufelt CL.RecentReview 4. Lipoprotein(a) and Women's Cardiovascular Health: A Review. JACC. Advances. 2026. Michos ED, Saucier S, Mehran R, Koschinsky ML. 5. Lipid Metabolism in Women: A Review. Atherosclerosis. 2025. van Oortmerssen JAE, Mulder JWCM, Kavousi M, Roeters van Lennep JE.Review 6. Are Changes in Cardiovascular Disease Risk Factors in Midlife Women Due to Chronological Aging or to the Menopausal Transition?. Journal of the American College of Cardiology. 2009. Matthews KA, Crawford SL, Chae CU, et al.Observational 7. Trajectories of Lipids Around the Menopause Transition in Chinese Women: Results of the Kailuan Cohort Study. Fertility and Sterility. 2023. Dai Q, Wu S, Cao Z, et al. 8. Lipid Management in Patients With Endocrine Disorders: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism. 2020. Newman CB, Blaha MJ, Boord JB, et al.Guideline 9. The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis. Frontiers in Pharmacology. 2022. Nie G, Yang X, Wang Y, et al.SR 10. Perspectives on Dyslipidemia and Coronary Heart Disease in Women. Journal of the American College of Cardiology. 2005. Bittner V.Review 11. Dyslipidemia in Midlife Women: Approach and Considerations During the Menopausal Transition. Maturitas. 2022. Torosyan N, Visrodia P, Torbati T, Minissian MB, Shufelt CL.Review 12. Effects of gender, age and menopausal status on serum apolipoprotein concentrations.13.Lipoprotein(a).The Journal of the American Medical Association. 2025. Mora S, Kronenberg     14. Why, how and in whom should we measure levels of lipoprotein(a): A review of the latest evidence and clinical implications. Diabetes, Obesity & Metabolism. 2025. Razavi AC, Bhatia HS, Blumenthal RS, Shapiro MD, Mehta A.RecentReview 15. Red Yeast Rice for Hypercholesterolemia: JACC Focus Seminar. Journal of the American College of Cardiology. 2021. Cicero AFG, Fogacci F, Zambon A.Review 16. Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Drugs. 2023. Blais JE, Huang X, Zhao JV.SR 17. Non-Genetic Influences on Lipoprotein(a) Concentrations. Atherosclerosis. 2022. Enkhmaa B, Berglund L.Review 18. NHLBI Working Group Recommendations to Reduce Lipoprotein(a)-Mediated Risk of Cardiovascular Disease and Aortic Stenosis. Journal of the American College of Cardiology. 2018. Tsimikas S, Fazio S, Ferdinand KC, et al.Review 19. Consumption of a defined, plant‐based diet reduces lipoprotein(a), inflammation, and other atherogenic lipoproteins and particles within 4 weeks. Clinical Cardiology. 2018. Najjar RS, Moore CE, Montgomery BD. 20. Lipoprotein(a): Current Evidence for a Physiologic Role and the Effects of Nutraceutical Strategies. Clinical Therapeutics. 2019. Santos HO, Kones R, Rumana U, et al.Review 21. Effect of Lipid-Lowering Therapies on Lipoprotein(a) Levels: A Comprehensive Meta-Analysis of Randomized Controlled Trials. Atherosclerosis. 2025. Xie S, Galimberti F, Olmastroni E, et al.Recent 22. Effect of Omega-3 Fatty Acid Supplementation on the Postprandial Metabolism of Apolipoprotein(a) in Familial Hypercholesterolemia. Journal of Atherosclerosis and Thrombosis. 2023. Ying Q, Croyal M, Chan DC, et al.RCT 23.Lipoprotein(a) and Cardiovascular Disease. Lancet. 2024. Nordestgaard BG, Langsted A.Review 24. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arteriosclerosis, Thrombosis, and Vascular Biology. 2022. Reyes-Soffer G, Ginsberg HN, Berglund L, et al.Guideline 25.Clinical Trial Design for Lipoprotein(a)-Lowering Therapies: JACC Focus Seminar 2/3.Journal of the American College of Cardiology. 2023. Malick WA, Goonewardena SN, Koenig W, Rosenson RS.Review 26.2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American Collegeof Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026. Writing Committee Members, Blumenthal RS, Morris PB, et al.Guideline 27. Noninvasive Coronary Atherosclerotic Plaque Imaging. JACC. Cardiovascular Imaging. 2023. Kwiecinski J, Tzolos E, Williams MC, et al.Review 28. Computed Tomography Angiography Versus Agatston Score for Diagnosis of Coronary Artery Disease in Patients With Stable Chest Pain: Individual Patient Data Meta-Analysis of the International COME-CCT Consortium. European Radiology. 2022. Wieske V, Walther M, Dubourg B, et al.SR 29. Association of Coronary Artery Calcium Score With Qualitatively and Quantitatively Assessed Adverse Plaque on Coronary CT Angiography in the SCOT-HEART Trial. European Heart Journal. Cardiovascular Imaging. 2022. Osborne-Grinter M, Kwiecinski J, Doris M, et al.Clinical Trial 30. AI-Guided Quantitative Plaque Staging Predicts Long-Term Cardiovascular Outcomes in Patients at Risk for Atherosclerotic CVD. JACC. Cardiovascular Imaging. 2024. Nurmohamed NS, Bom MJ, Jukema RA, et al.Observational 31. The Lancet Commission on Rethinking Coronary Artery Disease: Moving From Ischemia to Atheroma. Lancet. 2025. Zaman S, Wasfy JH, Kapil V, et al.Review 32. Efficacy and safety of novel lipoprotein(a)‐targeted therapies: A systematic review and meta‐analysis of randomized controlled trials. Diabetes, Obesity & Metabolism. 2026. Santana AUL, Yusufzai MO, Freitas APS, et al. Recent Opinion

Read the article here: https://journals.sagepub.com/doi/full/10.1177/30494826261468625

Aortic Stenosis in the Younger Patient in 2026   Guest: Mackram Eleid, M.D. Host: Malcolm Bell, M.D.   Dr. Malcolm Bell interviews Dr. Malcolm Eleid on the diagnosis and management of aortic stenosis in younger patients, as well as discussing patient-centered decision-making considerations for lifetime management of aortic stenosis. After review, listeners will understand current indications as well as advantages and disadvantages of transcatheter versus aortic valve replacement for younger patients with aortic stenosis.    Topics Discussed: What factors are taken into account when considering lifetime management of aortic stenosis? Can valve in valve be performed inside of a transcatheter aortic valve replacement (TAVR) prosthesis? Who are the patients that are better served with surgical aortic valve replacement (SAVR)?   Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode.   Podcast episode transcript found here.   Recorded on: 28-January-2026  

Commentary by Dr. Jae-Sik Jang.

Is there evidence for statins in the treatment of aortic valve stenosis?How the bacteria behind gum disease can affect heart healthWouldn't it be better to resume taking probiotics after finishing a round of antibiotics?Would it be safe to take olive leaf extract with amoxicillin?I'm considering surgery for varicose veins. Is this just a temporary fix? Can they return?

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Drs. Michael Mack and Tom Nguyen about the proposed US Centers for Medicare & Medicaid Services changes to how cardiologists and cardiac surgeons interact during transcatheter aortic valve replacement (TAVR) procedures. Chapters 00:00 Intro 01:21 TAVR Heart Team 04:08 JANS 1+2, JACC TAVR vs SAVR 12:19 JANS 3, TAVR Short-Term Outcomes 14:06 JANS 4, SAVR Life Expectancy 17:44 JANS 5, WSJ TAVR Article 19:19 Video 1, Direct AA Cannulation Technique 21:23 Video 2, Endoscopic Redo TVR After CABG 24:25 Video 3, Gaudiani Cox-Maze III 27:33 Dr. Mack & Nguyen, TAVR Heart Team 51:12 Closing Dr. Mack explained the current heart team system, established in 2011 through collaboration with the US Food and Drug Administration (FDA) and CMS, which has been highly successful in ensuring safe and effective TAVR implementation. He argues that the proposed CMS changes could potentially dismantle this collaborative approach by allowing asynchronous patient evaluation and procedures to be performed by single operators without surgeon involvement. Dr. Nguyen provided insights from a system leader's perspective, noting that while the proposed changes raise significant concerns about patient care and data collection, some cardiologists argue that surgeons are already not actively involved in many programs, making the single operator model the norm in practice. Both expressed concern that without mandatory surgeon participation and TAVR registry involvement, smaller programs may adopt practices that lack proper accountability and could lead to inappropriate patient selection and outcomes, potentially creating more contentious debates between TAVR and surgical approaches. Joel also highlights recent JANS articles including a propensity-matched analysis comparing 10-year outcomes after SAPIEN 3 TAVR in the PARTNER 2 SAPIEN 3 Intermediate-risk Registry with surgery in the PARTNER 2A trial; a single-center retrospective study evaluated 61 patients who underwent cardiac surgery after prior TAVR during a 10-year period at a high-volume academic center; whether surgical aortic valve replacement (SAVR) should remain the first choice for aortic stenosis in patients with a life expectancy beyond five years; and an article examining the dramatic rise in the popularity of transcatheter aortic valves, early valve failure, and the impact it has on patients' lives. In addition, Joel explores axillary cannulation as a primary cannulation strategy, beating-heart endoscopic tricuspid valve replacement for high-risk redo patients after CABG and device-related tricuspid valve injury, and a Cox-Maze III operation combined with a left internal mammary artery (LIMA) to left anterior descending artery (LAD), as well as an ascending aortic replacement and aortic valve resuspension. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned 10-Year Outcomes of SAPIEN 3 Transcatheter Aortic Valve Replacement or Surgery in Intermediate-Risk Patients A Decade of Cardiac Surgery After Transcatheter Aortic Valve Replacement: Short-Term Clinical Outcomes at a High-Volume Center Great Debate: Surgical Aortic Valve Replacement Is First Choice for Aortic Stenosis in Patients With a Life Expectancy Beyond 5 Years A Breakthrough Heart Procedure Comes With Risky Tradeoffs CTSNet Content Mentioned Direct Axillary Artery Cannulation With the Open Seldinger Technique Endoscopic Redo Tricuspid Valve Replacement After CABG The Cox-Maze III Procedure Combined With Valve-Sparing Aortic Surgery and CABG Other Items Mentioned Centers for Medicare & Medicaid Services Database—TAVR Career Center CTSNet Events   Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

Nature or nurture—which is more important when it comes to health conditions?Would I benefit from taking nattokinase along with my statin?Mechanism of action of nattokinase vs. statin medications on coronary artery health

Read the article here: https://journals.sagepub.com/doi/full/10.1177/30494826261448098

Around 4% of the global population has aortic stenosis, and early identification is key to reducing strain on the heart and reducing morbidity and mortality. Guest Alicia White, MSN, RN, describes signs and symptoms, diagnosis, treatment, and follow-up care following procedures.Related PCNA CE course:Aortic Stenosis: An increasing risk for structural heart disease: https://pcna.net/course/aortic-stenosis-an-increasing-risk-for-structural-heart-disease/See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Drs. Dasgupta and Sarswat review how ATTR cardiomyopathy remains under-recognized despite its prevalence in older patients with heart failure, emphasizing clinical red flags across cardiac and systemic manifestations. They outline a practical diagnostic pathway that prioritizes early identification using light-chain evaluation, bone scintigraphy, and genetic testing to distinguish transthyretin subtypes and initiate timely, disease-modifying therapy.

LBCT: Health Status Outcomes Seven Years After Transcatheter or Surgical Aortic Valve Replacement in Low Surgical Risk Patients with Severe Aortic Stenosis

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Long-Term Outcomes of Targeted Volume Overload Management in Patients With Severe Aortic Stenosis.

LBCT: Six-year Outcomes of Patients with Aortic Stenosis in The Evolut Low Risk Trial

Interview with Ankur Kalra, MD

With Jolanda Sabatino, Magna Graecia University of Catanzaro, Catanzaro - Italy, Salvatore De Rosa, Magna Graecia University of Catanzaro, Catanzaro - Italy and Daniele Torella, Magna Graecia University of Catanzaro, Catanzaro - Italy Link to European Heart Journal paper Link to European Heart Journal editorial

Another positive digoxin trial, another classic coronary physiology study from Imperial College London (ORBITA-FIRE), news in hypertrophic cardiomyopathy, and TAVR done in the wrong patients are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Digoxin in Rheumatic Heart Disease Dig-RHD Trial https://jamanetwork.com/journals/jama/fullarticle/2848973 Safety and Efficacy of Digoxin: Meta-Analysis https://www.bmj.com/content/351/bmj.h4451.long DIGIT-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415471 DIG Trial https://www.nejm.org/doi/full/10.1056/NEJM199702203360801 RADIANCE Trial https://www.nejm.org/doi/full/10.1056/NEJM199307013290101 II The Physiologic Threshold for Angina ORBITA-FIRE Trial https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.125.078738 III Prediction in Hypertrophic Cardiomyopathy Predictors of Long-Term Outcomes in HCM https://jamanetwork.com/journals/jama/fullarticle/2848800#250998713 IV TAVR Trends in Young Patients Temporal Trends in AVR for Aortic Stenosis in Patients < 65 https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.126.016826 Wall Street Journal article https://www.wsj.com/health/healthcare/heart-valve-tavr-surgery-aorta-1e0eda70 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

LBCT: Health Status Outcomes Seven Years After Transcatheter or Surgical Aortic Valve Replacement in Low Surgical Risk Patients with Severe Aortic Stenosis

Read the article here: https://journals.sagepub.com/doi/full/10.1177/30494826261424811

LBCT: Novel Balloon-expandable Transcatheter Heart Valve For Aortic Stenosis: Initial Insights From The Early Feasibility Study

A quiet valve, a loud message.

Program notes:0:36 High versus standard-dose flu vaccines in older people1:36 Cardiovascular outcomes2:26 Also in those with previous CVD3:10 Cooking and dementia risk4:10 Cooking frequency and skills assessment5:10 Tasks relative to preparing a meal at home6:10 Encourage home cooking6:30 Asymptomatic aortic stenosis treatment7:30 Replace valve before symptoms8:30 Trained cardiologist can grade9:10 Pediatric sepsis in U.S. hospitals10:17 About 51,000 cases11:17 Adult criteria may not be in EHR12:29 End

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Sameer Hirji, an associate surgeon at Brigham and Women's Hospital in Boston, MA, USA, about a paper he presented on at the 62nd Society of Thoracic Surgeons Annual Meeting titled “Concerning Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER.” Chapters 00:00 Intro  02:38 JANS 1, Female CT Surgeons NYT Article  04:38 JANS 2, Biopros vs Mech SAVR >65 YO  07:32 JANS 3, Fissure Last Tech, Randomized Trial  09:58 JANS 4, Ozaki Procedure, Perf & Durability  12:46 Video 1, MI Left Atrial Myxoma Resection  14:43 Video 2, Conduction System-Sparing Modified AVR  16:42 Video 3, RCAA w Coronary SF  18:55 Dr. Hirji, CDC WONDER Aortic Stenosis  31:40 Upcoming Events  32:11 Closing They discussed the study itself, including its overall results, as well as the demographic factors analyzed—such as race, gender, and location—and the results related to these demographics. They also addressed the limitations of the data used and explored possible reasons for the observed results, such as intervention strategies, underdiagnosis, and the prevalence of asymptomatic patients. The conversation further emphasized the importance of patient selection and the heart team.  Joel also highlights recent JANS articles on female cardiothoracic surgeons, unlocking the male fortress, bioprosthetic versus mechanical surgical aortic valve replacement in patients ≥65 years of age, results from a prospective randomized controlled trial on if the fissure last technique really reduces postoperative air leak after lung resection, and mid-term valve performance and durability of the Ozaki procedure in patients on chronic dialysis.  In addition, Joel explores a minimally invasive left atrial myxoma resection, safety and efficacy of a cardiac conduction system-sparing modified aortic valve replacement, and a surgical approach to right coronary artery aneurysm with coronary sinus fistula. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1. Female Cardiothoracic Surgeons, Unlocking the Male Fortress  2. Bioprosthetic Versus Mechanical Surgical Aortic Valve Replacement in Patients ≥65 Years of Age  3. Does the Fissure Last Technique Really Reduce Postoperative Airleak After Lung Resection? Results From a Prospective Randomized Controlled Trial   4. Mid-Term Valve Performance and Durability of the Ozaki Procedure in Patients on Chronic Dialysis  CTSNet Content Mentioned  1. Minimally Invasive Left Atrial Myxoma Resection   2. Safety and Efficacy of a Cardiac Conduction System-Sparing Modified Aortic Valve Replacement   3. Surgical Approach to Right Coronary Artery Aneurysm With Coronary Sinus Fistula   Other Items Mentioned  1. ‘Concerning' Trends Seen in Aortic Stenosis-Related Mortality: CDC WONDER   2. Career Center   3. CTSNet Events Calendar    Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making. ⚠️ SIGN UP FOR OUR FREE NEWSLETTER: [NEWSLETTER SIGN-UP]Topics included in this episode:Why myocardial ischemia is the main cause of perioperative collapse in severe aortic stenosisCore anesthetic goals: maintain preload, afterload, sinus rhythm, and controlled HRHow to choose anesthesia type and airway strategy in urgent noncardiac surgery with ASPractical induction tactics to avoid hypotension and sympathetic surgesIntraop and postop management strategies to preserve coronary perfusion and oxygen deliveryTo contact Alex Gorman, CRNA, you can email him at: gorman82@hotmail.com

Commentary by Dr. Jian'an Wang.

Commentary by Dr. Jasimuddin Ahamed.

What are your thoughts on the efficacy of strontium for bone health?What to you think of HRT for bone health?I have aortic valve stenosis. Is there any alternative to surgery?I have dry eyes after cataract surgeryAre there any benefits to Deer Antler for increasing HGH?

For dark days, get some sun in your eyesThe misleading vegan diet twin studyA least favorite thing from one of our listeners

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Differences in Severity and Prognosis Between Bicuspid and Tricuspid Severe Aortic Stenosis.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Sex Differences in the Clinical Recognition of Significant Aortic Stenosis.

Aaysha Cader, MD MSc, social media editor for JACC: Cardiovascular interventions and Christoph Ryffel, MD discuss the Long-term Outcomes of Patients with Moderate and Severe Aortic Stenosis According to Stages of Cardiac Damage, manucript published in the October 27 issue of the journal.

CardioNerds (Drs. Amit Goyal, Elizabeth Davis, and Keerthi Gondi) discuss the approach to asymptomatic severe aortic stenosis with expert faculty Drs. Parth Desai and Tony Bavry.   They review the natural history of aortic stenosis, current guidelines for treating severe aortic stenosis, multiparametric risk stratification, trial data on aortic valve replacement for patients with asymptomatic severe aortic stenosis, and a practical approach for our patients today.   This episode was supported by an educational grant from Edwards Lifesciences. All CardioNerds education is planned, produced, and reviewed solely by CardioNerds.  Enjoy this Circulation Paths to Discovery article to learn more about the CardioNerds mission and journey.  US Cardiology Review is now the official journal of CardioNerds! Submit your manuscripts here.  CardioNerds Aortic Stenosis SeriesCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron!

Long-term Hemodynamic Performance And Clinical Outcomes In Small And Large Aortic Annuli Patients With Severe Aortic Stenosis

5-year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Risk of Myocardial Infarction in Patients With Aortic Stenosis: Insights From the VALVENOR Registry.

Hosts Mitsuaki Sawano, MD, co-host Shun Kohsaka, MD, and Nobuhiro Ikemura, MD, welcome Tomohiko Taniguchi, MD, from Kobe City Medical Center General Hospital, to discuss findings from the CURRENT AS Registry-2 on low-gradient severe aortic stenosis (AS). Based on data from over 3,300 patients across 21 Japanese centers, the study categorized AS into four hemodynamic subtypes, revealing that low-gradient AS with reduced LVEF had the poorest prognosis, paradoxical LFLG AS was associated with high rates of atrial fibrillation and advanced cardiac damage despite low valve calcification, and normal-flow LG AS frequently exceeded guideline-based calcification thresholds despite being labeled as moderate. Dr. Taniguchi emphasizes the need to revise conventional illustrations of AS subtypes by incorporating cardiac damage and frailty and underscores the importance of proper statistical interpretation in subgroup analyses.

Progression And Outcomes of Mild to Moderate Aortic Stenosis: Insights from The GUARD Prospective Observational Study

In this podcast, Dr. Valentin Fuster reviews a pivotal study comparing the five-year outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in low-risk patients with severe aortic stenosis. The study found that both treatments yielded similar mortality and stroke rates, reinforcing TAVR's non-inferiority to surgery, though long-term outcomes in younger patients and the impact of pacemaker implantation remain areas of concern.

In this podcast, Dr. Valentin Fuster discusses a groundbreaking study on mild aortic stenosis, which redefines its diagnostic threshold using deep learning and velocity-encoded MRI. The findings suggest that even mild cases, previously considered benign, are linked to increased cardiovascular risks, highlighting the potential for early intervention and the critical role of AI in advancing cardiovascular research.

Hosts Mitsuaki Sawano, MD, and Shun Kohsaka, MD, FACC, welcome Saki Ito, MD, a physician scientist at the Mayo Clinic, to discuss key topics expected at the upcoming ACC.25 in Chicago and a nuanced phenotype of aortic stenosis (AS): high-gradient AS with an aortic valve area (AVA) greater than 1.0 cm². Drawing from a recent retrospective study at Mayo Clinic, Dr. Ito examines the heterogeneous nature of this group—including patients with bicuspid valves and elevated stroke volume due to larger body size—and the potential prognostic benefit of aortic valve replacement (AVR) despite the absence of classic severity markers.

In this episode, Dr. Valentin Fuster summarizes the March 11, 2025 issue of the JACC, which features groundbreaking research on transcatheter aortic valve replacement (TAVR) and its expanding applications. The podcast delves into the latest studies on TAVR's impact on heart failure patients, the need for better patient selection, and how new findings are shaping the future of aortic stenosis treatment.

In this episode, Dr. Valentin Fuster summarizes the March 11, 2025 issue of the JACC, which features groundbreaking research on transcatheter aortic valve replacement (TAVR) and its expanding applications. The podcast delves into the latest studies on TAVR's impact on heart failure patients, the need for better patient selection, and how new findings are shaping the future of aortic stenosis treatment.

In this episode, Dr. Valentin Fuster summarizes the March 11, 2025 issue of the JACC, which features groundbreaking research on transcatheter aortic valve replacement (TAVR) and its expanding applications. The podcast delves into the latest studies on TAVR's impact on heart failure patients, the need for better patient selection, and how new findings are shaping the future of aortic stenosis treatment.

The EVOLVED trial investigated whether early aortic valve intervention could improve outcomes in asymptomatic patients with severe aortic stenosis and myocardial fibrosis. The randomized, multicenter study of 224 patients found no significant difference in all-cause mortality or unplanned aortic stenosis-related hospitalizations between early intervention and guideline-directed conservative management. However, early intervention was associated with lower rates of NYHA class II-IV symptoms and fewer unplanned hospitalizations. The trial highlights the potential symptomatic benefits of early intervention but underscores the need for further research to assess long-term outcomes.

Recent randomized trials, including EARLY TAVR, AVATAR, RECOVERY, and EVOLVED, suggest benefits of early aortic valve replacement (AVR) in asymptomatic severe aortic stenosis (AS). Early AVR reduces stroke, heart failure hospitalizations, and cardiovascular events, with a trend toward improved survival. The data support shifting from clinical surveillance to early intervention?

The TCW Trial compared TAVI + FFR-guided PCI versus SAVR + CABG in patients with severe aortic stenosis and complex coronary artery disease. This multicenter, randomized controlled trial included 172 patients aged ≥70 years. At 1 year, the primary composite endpoint (death, MI, stroke, revascularization, valve reintervention, or major bleeding) was significantly lower in the TAVI + PCI group (4%) compared to SAVR + CABG (23%), meeting both noninferiority and superiority criteria. The study suggests TAVI + PCI as a safer, less invasive alternative with reduced mortality and bleeding risks in selected patients.

This episode covers paediatric aortic stenosis.Written notes can be found at https://zerotofinals.com/paediatrics/cardiology/paediatricaorticstenosis/Questions can be found at https://members.zerotofinals.com/Books can be found at https://zerotofinals.com/books/The audio in the episode was expertly edited by Harry Watchman.

Calcific aortic stenosis affects approximately 12% of people >75 years in the US and worldwide leads to more than 100 000 deaths each year. Catherine M. Otto, MD, PhD, of the University of Washington School of Medicine, Seattle, discusses the symptoms, diagnosis, and treatment of aortic stenosis with JAMA Deputy Editor Kristin L. Walter, MD, MS. Related Content: Calcific Aortic Stenosis

Author Nicolas M. Van Mieghem, MD, PhD, FACC, and JACC: Executive Associate Editor Aakriti Gupta, MD, FACC,  discuss the TAVR UNLOAD trial, which focused on patients with moderate aortic stenosis (AS) and reduced ejection fraction (HFrEF). The trial found no significant difference in the primary endpoint (composite of mortality, stroke, and hospitalizations) between the TAVR and clinical surveillance groups. However, patients who underwent TAVR showed a significant improvement in quality of life at one year. The conversation highlighted the need for individualized treatment approaches, emphasizing patient selection, while also considering trial limitations, including slow enrollment and study size.