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TAVI Indication — RACP Adult Medicine MCQ

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EasyCardiologyTAVI IndicationRACP Adult Medicine

An 82-year-old woman with severe symptomatic aortic stenosis has STS score 8% (high surgical risk), significant frailty, and porcelain aorta. She has NYHA III symptoms. LVEF is 50%. What is the most appropriate intervention?

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Correct answer: A — Transcatheter aortic valve implantation (TAVI)

Severe symptomatic AS in an elderly frail patient with high surgical risk (STS >8%) and porcelain aorta (calcified aorta — precludes clamping for SAVR) is an indication for TAVI. TAVI is delivered via transfemoral (preferred), transapical, or subclavian approach. Self-expanding or balloon-expandable valves are available. TAVI has transformed management of high-risk AS, with procedural mortality <2%.

Reference: CSANZ – 2024 – VHD; ESC 2021 VHD; PARTNER/Evolut Trials