. Author manuscript; available in PMC: 2016 Nov 29.

Published in final edited form as: Nat Rev Dis Primers. 2016 Mar 3;2:16006. doi: 10.1038/nrdp.2016.6

Table 3.

Key management decisions when selecting a technique and prosthetic valve for aortic valve replacement.

AVR technique or valve type	Indication	Contra-indication	Advantages	Limitations
Surgical AVR	Indication of AVR Low to high surgical risk	Prohibitive surgical risk Life expectancy < 1 year	Standard therapy with well-established record of safety, efficacy and durability	Invasive
Surgical AVR with biological valve	Patient preference Achievement of good anticoagulation unlikely Age > 65 years	Life expectancy < 1 year	Does not require anticoagulation	Limited long-term durability
Surgical AVR with mechanical valve	Patient preference Patients already on anticoagulation	Life expectancy < 1 year	Long-term durability	Requires life-time anticoagulation (increased risk of bleeding)
Transcatheter AVR^*	Indication of AVR High or prohibitive surgical risk	Life expectancy < 1 year	Less invasive than surgical AVR	Long-term durability unknown Higher risk of paravalvular AR

With balloon-expandable or self-expanding valves.

AR, aortic regurgitation; AVR, aortic valve replacement