Aortic stenosis (AS) refers to aortic valve narrowness due to organic lesions of the heart's aortic valve. This restricts the blood flow from the left ventricle to the aorta, resulting in elevated left ventricular pressure and centripetal hypertrophy. It can also lead to decreased aortic pressure, with common symptoms including dyspnea, angina pectoris and syncope. If no treatment is provided, the patient's condition may worsen and become life-threatening. The etiology of aortic stenosis includes congenital factors (mainly congenital bicuspid aortic valve disease), rheumatism and calcification. Dyspnea, angina pectoris, and syncope are the common triad in typical aortic stenosis, which often occurs at a later stage ^[1]_.

In western countries, the incidence of AS is about 2.0% in people aged ≥65 and about 4.0% in people aged 85. It is a cardiovascular disease with a high incidence rate, second only to coronary heart disease and hypertension ^[2-4]. It has become the primary cause of aortic valve replacement and the most common heart valve disease among elderly. The epidemiological characteristics of aortic diseases in China are distinctly different from those in foreign countries. The incidence of aortic stenosis (AS) in foreign countries is higher than that of aortic regurgitation (AR) ^[5], while in China, aortic regurgitation (AR) is more common than aortic stenosis (AS) ^[6].

There is no effective medication for severe aortic stenosis. For calcified leaflets in adults, balloon dilatation can only temporarily improve symptoms, but not the survival rate ^[7]. Artificial aortic valve replacement is the gold standard of intervention for various types of aortic valve lesions. According to the latest guidelines ^[8]_.

1. If feasible, transfemoral (TF) TAVR is preferred for patients aged >80 or with a life expectancy of <10 years.

2. For symptomatic patients aged 65-80 without TF TAVR contraindications, it is recommended that the doctor and the patient make a joint decision between SAVR and TF TAVR.

3. If the expected survival after intervention is >12 months and the quality of life is deemed acceptable, TAVR is preferred for patients of any age with symptoms, high surgical risk, or surgical contraindications.

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