{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:19:37Z","timestamp":1783423177752,"version":"3.54.6"},"reference-count":52,"publisher":"IMR Press","issue":"6","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) have transformed the management of severe aortic stenosis across a wide range of patient risk profiles. As populations age and indications extend to lower-risk and younger patients, determining the appropriate role of age in selecting TAVR versus SAVR has become increasingly complex. Current guidelines emphasize individualized decision-making, yet age-based referral patterns remain common in clinical practice. This review examines how age thresholds are applied in contemporary guidance from the United States (US), Europe, and the Asia-Pacific region. Additionally, this review evaluates whether chronological age alone is a defensible basis for referral or treatment selection. This evidence-based narrative review queried PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) from January 1, 2013, through December 31, 2025, using the search terms: (\"aortic stenosis\" AND (\"TAVR\" OR \"transcatheter aortic valve implantation (TAVI)\" OR \"SAVR\")) AND (\"age\" OR \"appropriateness\"). English-language abstracts and full texts were screened in duplicate. Eligible studies included randomized controlled trials, national or continental registries, health economic simulations, and clinical practice guidelines that reported age-stratified outcomes or recommendations. Single-case reports, editorials, and animal studies were excluded. Of the 1628 titles screened, 87 full texts were reviewed, and 45 studies were retained. Across regions, guidelines converge on a core principle: age is informative but insufficient in isolation. U.S. guidance generally favors SAVR in patients younger than 65 years or those with a life expectancy greater than 20 years, and favors transfemoral TAVR in patients older than 80 years or with a life expectancy shorter than 10 years. European guidance typically favors SAVR in patients younger than 75 years and TAVR in those older than 75 years. Meanwhile, Asia-Pacific recommendations adopt a similarly individualized approach but place greater emphasis on bicuspid anatomy, rheumatic disease, local health system infrastructure, and cost. Recent data support a cautious approach in younger patients. In observational U.S. analyses of patients younger than 65 years, TAVR use increased substantially despite guideline preference for surgery, and TAVR was associated with higher long-term mortality or higher pacemaker and readmission burdens in selected cohorts. Contemporary randomized data suggest broadly similar outcomes between TAVR and SAVR in older or intermediate-age populations; however, uncertainty persists in younger low-risk patients, particularly those with bicuspid anatomy and long projected survival. Age-based cutoffs should be interpreted as decision anchors rather than rigid rules. The most defensible framework integrates age with life expectancy, valve durability, anatomy, frailty, comorbidity burden, coronary artery disease, feasibility of future valve-in-valve therapy, and patient preferences within a multidisciplinary heart team. Expansion of TAVR into younger populations should remain measured until more robust long-term durability and lifetime management data become available.<\/jats:p>","DOI":"10.31083\/rcm49368","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:06:15Z","timestamp":1783422375000},"source":"Crossref","is-referenced-by-count":0,"title":["International Age and Use Criteria for Transcatheter and Surgical Aortic Valve Replacement"],"prefix":"10.31083","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7043-7185","authenticated-orcid":true,"given":"Rohit","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Medicine, Mass General Brigham-Salem Hospital, Salem, MA 01970, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2487-7219","authenticated-orcid":true,"given":"Sudarshan","family":"Srivats","sequence":"additional","affiliation":[{"name":"Department of Hospital Medicine, Catholic Medical Center, Manchester, NH 03102, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7121-8574","authenticated-orcid":true,"given":"Fateen","family":"Ata","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hamad Medical Corporation, 3050 Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2082-2637","authenticated-orcid":true,"given":"Jeffrey","family":"Shuhaiber","sequence":"additional","affiliation":[{"name":"The Wellman Institute of Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP 3rd, Gentile F, 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. 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Available at: https:\/\/www.ssa.gov\/oact\/STATS\/table4c6.html (Accessed: 20 December 2020). https:\/\/www.ssa.gov\/oact\/STATS\/table4c6.html"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Goldstone AB, Chiu P, Baiocchi M, Lingala B, Patrick WL, Fischbein MP, et al. Mechanical or Biologic Prostheses for Aortic-Valve and Mitral-Valve Replacement. The New England Journal of Medicine. 2017; 377: 1847\u20131857.","DOI":"10.1056\/NEJMoa1613792"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"van Geldorp MWA, Eric Jamieson WR, Kappetein AP, Ye J, Fradet GJ, Eijkemans MJC, et al. Patient outcome after aortic valve replacement with a mechanical or biological prosthesis: weighing lifetime anticoagulant-related event risk against reoperation risk. The Journal of Thoracic and Cardiovascular Surgery. 2009; 137: 881\u2013881\u20136, 886e1\u20135.","DOI":"10.1016\/j.jtcvs.2008.09.028"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Badhwar V, Ofenloch JC, Rovin JD, van Gelder HM, Jacobs JP. Noninferiority of closely monitored mechanical valves to bioprostheses overshadowed by early mortality benefit in younger patients. The Annals of Thoracic Surgery. 2012; 93: 748\u2013753.","DOI":"10.1016\/j.athoracsur.2011.12.032"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Brown ML, Schaff HV, Lahr BD, Mullany CJ, Sundt TM, Dearani JA, et al. Aortic valve replacement in patients aged 50 to 70 years: improved outcome with mechanical versus biologic prostheses. 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EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2012; 8: 383\u2013389.","DOI":"10.4244\/EIJV8I3A58"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Siontis GCM, Overtchouk P, Cahill TJ, Modine T, Prendergast B, Praz F, et al. Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: an updated meta-analysis. European Heart Journal. 2019; 40: 3143\u20133153.","DOI":"10.1093\/eurheartj\/ehz275"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Mori M, Gupta A, Wang Y, Vahl T, Nazif T, Kirtane AJ, et al. Trends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States. 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Cardiovascular Revascularization Medicine : Including Molecular Interventions. 2019; 20: 843\u2013851.","DOI":"10.1016\/j.carrev.2018.11.024"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Izumi C, Eishi K, Ashihara K, Arita T, Otsuji Y, Kunihara T, et al. JCS\/JSCS\/JATS\/JSVS 2020 Guidelines on the Management of Valvular Heart Disease. Circulation Journal : Official Journal of the Japanese Circulation Society. 2020; 84: 2037\u20132119.","DOI":"10.1253\/circj.CJ-20-0135"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"Li YM, Xiong TY, Xu K, Fang ZF, Jiang L, Jin J, et al. Characteristics and outcomes following transcatheter aortic valve replacement in China: a report from China aortic valve transcatheter replacement registry (CARRY). Chinese Medical Journal. 2021; 134: 2678\u20132684.","DOI":"10.1097\/CM9.0000000000001882"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Gupta P, Arora S, Qamar A, Gupta M, Seth A. Current status of transcatheter aortic valve replacement in India. Cardiovascular Diagnosis and Therapy. 2020; 10: 83\u201388.","DOI":"10.21037\/cdt.2019.05.04"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"Yoon SH, Ahn JM, Hayashida K, Watanabe Y, Shirai S, Kao HL, et al. Clinical Outcomes Following Transcatheter Aortic Valve Replacement in Asian Population. JACC. Cardiovascular Interventions. 2016; 9: 926\u2013933.","DOI":"10.1016\/j.jcin.2016.01.047"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"Tan ECH, Lee YT, Kuo YC, Tsao TP, Lee KC, Hsiung MC, et al. Clinical outcomes and cumulative healthcare costs of TAVR vs. SAVR in Asia. Frontiers in Cardiovascular Medicine. 2022; 9: 973889.","DOI":"10.3389\/fcvm.2022.973889"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"Zhang W, Lou Y, Liu Y, Wang H, Zhang C, Qian L. 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Journal of the American Heart Association. 2018; 7: e008440.","DOI":"10.1161\/JAHA.117.008440"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"Deutsch MA, Erlebach M, Burri M, Hapfelmeier A, Witt OG, Ziegelmueller JA, et al. Beyond the five-year horizon: long-term outcome of high-risk and inoperable patients undergoing TAVR with first-generation devices. EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2018; 14: 41\u201349.","DOI":"10.4244\/EIJ-D-17-00603"},{"key":"ref40","doi-asserted-by":"publisher","unstructured":"Didier R, Eltchaninoff H, Donzeau-Gouge P, Chevreul K, Fajadet J, Leprince P, et al. Five-Year Clinical Outcome and Valve Durability After Transcatheter Aortic Valve Replacement in High-Risk Patients. Circulation. 2018; 138: 2597\u20132607.","DOI":"10.1161\/CIRCULATIONAHA.118.036866"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"Pibarot P, Ternacle J, Jaber WA, Salaun E, Dahou A, Asch FM, et al. Structural Deterioration of Transcatheter Versus Surgical Aortic Valve Bioprostheses in the PARTNER-2 Trial. Journal of the American College of Cardiology. 2020; 76: 1830\u20131843.","DOI":"10.1016\/j.jacc.2020.08.049"},{"key":"ref42","doi-asserted-by":"publisher","unstructured":"Attinger-Toller A, Ferrari E, Tueller D, Templin C, Muller O, Nietlispach F, et al. Age-Related Outcomes After Transcatheter Aortic Valve Replacement: Insights From the SwissTAVI Registry. JACC. Cardiovascular Interventions. 2021; 14: 952\u2013960.","DOI":"10.1016\/j.jcin.2021.01.042"},{"key":"ref43","doi-asserted-by":"publisher","unstructured":"Hussain AI, Auensen A, Brunborg C, Beitnes JO, Gullestad L, Pettersen KI. Age-dependent morbidity and mortality outcomes after surgical aortic valve replacement. Interactive Cardiovascular and Thoracic Surgery. 2018; 27: 650\u2013656.","DOI":"10.1093\/icvts\/ivy154"},{"key":"ref44","doi-asserted-by":"publisher","unstructured":"J\u00f8rgensen TH, Thyregod HG, Savontaus M, Bleie \u00d6, Christiansen EH, Niemela M, et al. Transcatheter or surgical aortic valve replacement in patients with severe aortic stenosis aged 70 years or younger: A NOTION-2 substudy. American Heart Journal. 2025; 284: 67\u201370.","DOI":"10.1016\/j.ahj.2025.02.003"},{"key":"ref45","doi-asserted-by":"publisher","unstructured":"J\u00f8rgensen TH, Savontaus M, Willemen Y, Bleie \u00d8, Tang M, Anger\u00e5s O, et al. Three-Year Follow-Up of the NOTION-2 Trial: TAVR Versus SAVR to Treat Younger Low-Risk Patients With Tricuspid or Bicuspid Aortic Stenosis. Circulation. 2025; 152: 1326\u20131337.","DOI":"10.1161\/CIRCULATIONAHA.125.076678"},{"key":"ref46","doi-asserted-by":"publisher","unstructured":"Russo G, Tang GHL, Sangiorgi G, Pedicino D, Enriquez-Sarano M, Maisano F, et al. Lifetime Management of Aortic Stenosis: Transcatheter Versus Surgical Treatment for Young and Low-Risk Patients. Circulation. Cardiovascular Interventions. 2022; 15: 915\u2013927.","DOI":"10.1161\/CIRCINTERVENTIONS.122.012388"},{"key":"ref47","doi-asserted-by":"publisher","unstructured":"Tam DY, Wijeysundera HC, Naimark D, Gaudino M, Webb JG, Cohen DJ, et al. Impact of Transcatheter Aortic Valve Durability on Life Expectancy in Low-Risk Patients With Severe Aortic Stenosis. Circulation. 2020; 142: 354\u2013364.","DOI":"10.1161\/CIRCULATIONAHA.119.044559"},{"key":"ref48","doi-asserted-by":"publisher","unstructured":"S\u00e1 MPBO, Van den Eynde J, Simonato M, Cavalcanti LRP, Doulamis IP, Weixler V, et al. Valve-in-Valve Transcatheter Aortic Valve Replacement Versus Redo Surgical Aortic Valve Replacement: An Updated Meta-Analysis. JACC. Cardiovascular Interventions. 2021; 14: 211\u2013220.","DOI":"10.1016\/j.jcin.2020.10.020"},{"key":"ref49","doi-asserted-by":"publisher","unstructured":"Sharma T, Krishnan AM, Lahoud R, Polomsky M, Dauerman HL. National Trends in TAVR and SAVR for Patients With Severe Isolated Aortic Stenosis. Journal of the American College of Cardiology. 2022; 80: 2054\u20132056.","DOI":"10.1016\/j.jacc.2022.08.787"},{"key":"ref50","unstructured":"Caplan Z, Rabe M. The Older Population. 2023. Available at: https:\/\/www.census.gov\/library\/publications\/2023\/decennial\/c2020br-07.html (Accessed: 20 April 2023). https:\/\/www.census.gov\/library\/publications\/2023\/decennial\/c2020br-07.html"},{"key":"ref51","doi-asserted-by":"publisher","unstructured":"Alabbadi S, Malas J, Chen Q, Cheng W, Tam DY, Cohen RG, et al. Guidelines vs Practice: Surgical Versus Transcatheter Aortic Valve Replacement in Adults \u226460 Years. The Annals of Thoracic Surgery. 2025; 119: 861\u2013869.","DOI":"10.1016\/j.athoracsur.2024.07.036"},{"key":"ref52","doi-asserted-by":"publisher","unstructured":"Nwaedozie S, Zhang H, Najjar Mojarrab J, Sharma P, Yeung P, Umukoro P, et al. Novel predictors of permanent pacemaker implantation following transcatheter aortic valve replacement. 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