TAVR indications now include asymptomatic patients, with increasing use in younger populations.
Transcatheter aortic valve replacement (TAVR) was first approved by the U.S. Food and Drug Administration in 2011 for patients with prohibitive surgical risk. Since then, the procedure has steadily gained new indications. The FDA expanded approval to high-risk patients in 2012, intermediate-risk patients in 2016, and select low-risk populations by 2019.1 In 2025, regulatory actions and emerging evidence from EARLY TAVR supported expanded consideration of TAVR in selected asymptomatic severe aortic stenosis (AS) patients.2
As indications expanded, so too did procedure volume. Analysis of the Society of Thoracic Surgeons/American College of Cardiology (STS/ACC) Transcatheter Valve Therapy Registry covering 2012 through 2024, encompassing more than 580,000 TAVR patients, found that the number of participating hospitals grew from 161 to 726, and that low-risk cases increased substantially over time, reaching more than one-third of procedures in recent years. National data show TAVR exceeded the number of surgical aortic valve replacements (SAVR) in 2019 and now accounts for most aortic valve procedures in the United States.3
A regional study of New England cardiovascular programs found that TAVR utilization among patients under 65 undergoing isolated aortic valve replacement rose from 19% to 51.7%, increasing 270% over six years.4 This trend has drawn clinical attention because current American College of Cardiology/American Heart Association (ACC/AHA) guidelinesontinue to recommend SAVR for patients under 65 with a life expectancy greater than 20 years, reflecting limited long-term data in younger patients who were underrepresented in low-risk TAVR trials.5
Despite increased procedural volume, severe AS remains undertreated. A study of 24 U.S. hospitals found that among 12,129 individuals with documented severe AS, 40% remained untreated four years after diagnosis.6 Disparities persist by sex, and in some analyses women have demonstrated lower adjusted survival than men after age-matching.7
Take our aortic stenosis quiz to see how your knowledge compares to your peers.
[1] Mahmaljy H, Tawney A, Young M. Transcatheter Aortic Valve Replacement. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431075/
[2] FDA Update: Agency Approves TAVR Valves For Asymptomatic Severe AS – American College of Cardiology. American College of Cardiology. Published 2026. Accessed April 15, 2026. https://www.acc.org/latest-in-cardiology/articles/2025/05/01/16/09/fda-update-agency-approves-tavr-for-asymptomatic-severe-as
[3] Report Finds TAVR Is Dominant Form of Aortic Valve Replacement, Outcomes Steadily Improving in the United States Data from the STS/ACC TVT Registry Provides Insights on “State of TAVR in the United States.”Accessed April 15, 2026. https://www.sts.org/sites/default/files/press-releases/State%20of%20TAVR%20PR%20-%20FINAL.pdf
[4] Gupta T, DeVries JT, Gilani F, Hassan A, Ross CS, Dauerman HL. Temporal Trends in Transcatheter Aortic Valve Replacement for Isolated Severe Aortic Stenosis. J Soc Cardiovasc Angiogr Interv. 2024 Apr 5;3(7):101861. doi: 10.1016/j.jscai.2024.101861. PMID: 39132009; PMCID: PMC11308430.
[5] Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;143(5). doi: https://doi.org/10.1161/cir.0000000000000923
[6] Sharma T, Krishnan AM, Lahoud R, Polomsky M, Dauerman HL. National Trends in TAVR and SAVR for Patients With Severe Isolated Aortic Stenosis. J Am Coll Cardiol. 2022 Nov 22;80(21):2054-2056. doi: 10.1016/j.jacc.2022.08.787. Epub 2022 Sep 16. PMID: 36122626.
[7] Li SX, Patel NK, Flannery LD, Selberg A, Kandanelly RR, Morrison FJ, Kim J, Tanguturi VK, Crousillat DR, Shaqdan AW, Inglessis I, Shah PB, Passeri JJ, Kaneko T, Jassar AS, Langer NB, Turchin A, Elmariah S. Trends in Utilization of Aortic Valve Replacement for Severe Aortic Stenosis. J Am Coll Cardiol. 2022 Mar 8;79(9):864-877. doi: 10.1016/j.jacc.2021.11.060. PMID: 35241220.
