Summary

This article chronicles the history and progress of aortic valve replacement (AVR). The development of AVR surgery gave patients the opportunity to live longer, feel better, and benefit from improved left ventricular function [Bonow RO et al. Circulation 2008]. However, clinical trials in the 2000s revealed that >30% of patients with severe symptomatic aortic stenosis were untreated because they were elderly, had comorbidities with high operative risk, or refused surgery [Iung B et al. Eur Heart J 2005; Charlson E et al. J Heart Valve Dis 2006; Bach DS et al. Circ Cardiovascular Qual Outcomes 2009].