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The American College of Cardiology released checklists, building on current guidelines, to optimize transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis.

, released online in the Journal of the American College of Cardiology, now outline essential elements of patient selection and other pre-procedural considerations, testing and imaging, performing the TAVR procedure itself while minimizing complications, post-procedure management and long-term follow-up.

"TAVR is one of the most rapidly expanding technologies in medical care today, and as our population ages, we will see increasing numbers of people with severe aortic valve stenosis, so it is important to provide guidance on optimal use of this treatment," said , of University of Washington in Seattle and co-chair of the writing committee, in a statement.

"We set out to develop practice tools that could readily help centers -- those that either want to start doing TAVR or that are already performing it -- improve their processes, patient safety, and outcomes," she said. "The resulting checklists are designed as a starting point for managing patients who are being considered for TAVR."

Furthermore, "optimal care of these complex patients requires close collaboration between several different specialties as part of an integrated Heart Valve Team," Otto and co-authors wrote in the document.

The writing committee acknowledged that the TAVR procedure will change over the years, with a nod to the ongoing evolution of types and sizes of prosthetic valves available for TAVR, the continued improvement in implantation technique, and the changing (and perhaps lower-risk) TAVR population.

"However, the general principles outlined in this Decision Pathway will remain relevant to managing these patients in the future," they argued, even as heart valve centers expand and adjust the framework provided to meet each individual institution's needs.

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