2021 ESC/EACTS VHD Guidelines

  • All severe aortic stenosis (sAS) patients* should now be referred to the Heart Team for a treatment evaluation.1
  • TF-TAVI is recommended as preferred mode of intervention in patients ≥75 years of age**, as well as for additional patient groups < 75 years of age.1
  • The Heart Team recommendation should be discussed with the patient, who can then make an informed treatment decision between the option of TAVI or SAVR.1
*With a treatment indication
**Based on evaluation of clinical, anatomical and procedural factors
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Heart Team referral for choice of intervention

  • The 2021 ESC/EACTS Guidelines endorse an active and collaborative Heart Team be responsible for decisions concerning treatment and intervention.1
  • It is now recommended that all patients with sAS are referred to the Heart Team for a treatment evaluation regardless of surgical risk.1

The decision between TAVI and SAVR

Real-World studies, registries and clinical trials have informed the 2021 update to the guidelines leading to a revised set of treatment recommendations with age a key determining factor in deciding between TAVI or SAVR in sAS patients requiring treatment.

2021 ESC/EACTS recommendations for aortic stenosis management1

Further details on the management of valvular heart disease are available on ESC website

Treatment choice: a shared decision with your patient

  • The Heart Team evaluation is complex, involving multiple factors such as clinical, anatomical and procedural but should also include the patient’s goals.1
  • The 2021 ESC/EACTS Guidelines emphasise the need for patients to understand and decide on their preferred treatment.1 “The Heart Team recommendation should be discussed with the patient who can then make an informed treatment choice.”
Help your patients understand their treatment options, to make an informed decision.

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References

  • 1Vahanian A, et al. Eur Heart J. 2021; ehab395. doi:10.1093/eurheartj/ehab395

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