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TAVI at Low Surgical Risk — EECC MCQ

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EasyValvular Heart DiseaseTAVI at Low Surgical RiskEECC

A 72-year-old woman with severe aortic stenosis (AVA 0.6 cm², mean gradient 55 mmHg) and symptomatic angina is considered for TAVI. Her STS-PROM mortality score is 2.5% (low surgical risk). She has a tricuspid aortic valve and suitable femoral access. She is 72 years old. According to the 2025 ESC VHD Guidelines, is TAVI recommended?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Yes — TAVI is recommended for patients aged ≥70 years with tricuspid AV stenosis and suitable anatomy, irrespective of surgical risk

The 2025 ESC/EACTS VHD Guidelines lowered the age threshold for TAVI from ≥75 to ≥70 years for patients with tricuspid aortic valve stenosis and suitable anatomy, irrespective of surgical risk (Class I, LOE A). This was based on accumulating evidence from the DEDICATE-DZHK6, NOTION-2, and Evolut Low Risk trials demonstrating non-inferiority of TAVI to SAVR in patients aged 70-75. For patients <70 years with low surgical risk, SAVR remains recommended. The Heart Team should consider lifetime management, durability, need for future procedures, and patient preference in the final decision.

Reference: ESC/EACTS (2025): Guidelines for the Management of Valvular Heart Disease