Rosh Emergency Medicine Practice Test

What is the recommended surgical intervention for a patient diagnosed with severe aortic stenosis showing symptoms of heart failure?

1. Transcatheter aortic valve replacement (TAVR)

2. Coronary artery bypass grafting (CABG)

3. Valve repair with degenerated valve tissue replacement

4. Open-heart surgery for mechanical valve replacement

The correct answer is: Transcatheter aortic valve replacement (TAVR)

The recommended surgical intervention for a patient diagnosed with severe aortic stenosis who is showing symptoms of heart failure is transcatheter aortic valve replacement (TAVR). This procedure is particularly advantageous for patients who are at increased risk for traditional open-heart surgery due to advanced age or comorbid conditions. TAVR offers a less invasive alternative with a favorable safety profile and has been shown to provide significant symptom relief and improve quality of life. TAVR is performed via catheterization, which minimizes recovery times and reduces the overall surgical risk compared to open-heart procedures. It involves the implantation of a new valve through a blood vessel, which effectively relieves the obstruction caused by the stenosed aortic valve. Given the current evidence and guidelines, TAVR is considered a standard of care for symptomatic severe aortic stenosis, particularly in patients who are not candidates for surgical aortic valve replacement (SAVR). In contrast, coronary artery bypass grafting (CABG) primarily addresses coronary artery disease rather than valvular issues, which makes it unsuitable for treating isolated aortic stenosis. Valve repair with degenerated valve tissue replacement pertains to conditions that allow for repair rather than replacement, and often, aortic stenosis necessitates a valve