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Aortic Stenosis — UKMLA MCQ

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HardCardiologyAortic StenosisUKMLAMRCP Part 1

A 79-year-old has symptomatic severe non-bicuspid aortic stenosis. The heart team judges surgical risk high but anatomy suitable for either approach. Which intervention does NICE recommend offering if suitable?

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Correct answer: E — Transcatheter aortic-valve implantation after heart-team review

The best answer is “Transcatheter aortic-valve implantation after heart-team review”. NICE recommends TAVI for suitable adults with non-bicuspid severe aortic stenosis who are at high surgical risk or unsuitable for surgery. Surgical replacement remains first-line when an indicated patient is low or intermediate risk and suitable for surgery. Balloon valvuloplasty is usually a bridge or palliative option rather than durable definitive therapy. No medicine reverses fixed severe valve obstruction, and coronary revascularisation alone does not address symptomatic critical stenosis. The multidisciplinary valve team integrates anatomy, frailty, life expectancy and patient preference.

Reference: NICE NG208: Heart valve disease presenting in adults: https://www.nice.org.uk/guidance/ng208/chapter/Recommendations