Management of aortic stenosis: lifetime management is a moving target

Abstract

We read with great interest the thoughtful article by Hamana and colleagues regarding lifetime management and reintervention after transcatheter aortic valve replacement (TAVR) (1). Their review appropriately highlights the growing importance of structural valve deterioration as TAVR expands into younger and lower-risk populations and provides an excellent overview of the pathological mechanisms underlying bioprosthetic valve failure. We agree that reintervention is no longer an exceptional event but an anticipated component of caring for patients with severe aortic stenosis. We would, however