Aortic stenosis is a narrowing of the heart's aortic valve that blocks blood flow from the heart to the body. It affects about 2-7% of people over 65 and worsens gradually over years. Treatment now includes open-heart surgery and TAVR — a catheter-based valve replacement done without opening the chest — which has become the dominant option for older patients.
What's actually going on in research
Trials are testing TAVR in younger patients and those with less severe stenosis, studying how early intervention affects outcomes. Researchers are developing longer-lasting valve designs, testing medications to slow valve calcification before replacement is needed, and exploring ways to prevent structural valve deterioration. Studies are also examining biomarkers that predict disease progression and optimal timing for intervention.
Early intervention
Trials are testing whether replacing the valve before symptoms appear prevents heart damage. Results could shift when patients with moderate stenosis get TAVR instead of waiting for severe disease.
Valve durability
New valve designs and coatings aim to last longer and resist calcification. This matters especially for younger patients who may outlive current valves.
Medical therapy
Trials are testing statins and other drugs to slow calcium buildup in the valve. If successful, medications could delay or prevent the need for valve replacement.
What to know before you search
Eligibility typically depends on stenosis severity, symptoms, heart function, surgical risk score, valve anatomy, and whether you've had prior valve procedures.
What types of trials are currently open
- TAVR trials — Testing catheter-based valve replacement in different patient groups — younger people, those with moderate stenosis, or those at low surgical risk.
- Valve technology trials — Comparing new valve designs, materials, or deployment techniques to improve durability and reduce complications.
- Medical therapy trials — Testing drugs that might slow valve calcification or protect the heart from stenosis-related damage.
- Timing studies — Following patients to determine the best moment to replace the valve — balancing risks of waiting against risks of early intervention.
- Registry studies — Tracking outcomes after TAVR or surgery to understand long-term valve performance and complication patterns.
Recently added Aortic Stenosis trials
TAVI and PCI in Comparison to SAVR and CABG in Low and Intermediate Risk Patients With Severe Aortic Stenosis
\# WHAT IS THIS STUDY ABOUT? This study compares two different treatment approaches for patients with two heart conditions occurring simultaneously: a narrowed heart valve (aortic stenosis) and narrowed or blocked heart arteries (coronary artery disease). Both conditions are serious and, when they occur together, place considerable strain on the heart. The heart must work harder to pump blood through the narrowed valve while simultaneously receiving an inadequate blood supply through the blocked coronary arteries. \# WHY IS THIS STUDY NEEDED? Until recently, the main treatment option for patients with both conditions was open-heart surgery. This major operation involves opening the chest, temporarily stopping the heart, replacing the heart valve with an artificial valve, and performing coronary artery bypass grafting to restore blood flow around the blocked arteries. Although effective, combined surgery carries significant risks, particularly in older or frailer patients, including prolonged recovery, longer hospital stays (often 2 to 3 weeks), bleeding, kidney injury, and other complications. A newer, less invasive treatment approach is now available. This involves replacing the heart valve through a thin tube (catheter) inserted through a blood vessel in the groin, without opening the chest, and treating the blocked coronary arteries using a fine wire, a small balloon, and a metal mesh tube (stent) placed inside the artery. This approach, known as transcatheter aortic valve implantation (TAVI) combined with percutaneous coronary intervention (PCI), typically requires a shorter hospital stay of approximately 2 to 4 days and may allow an earlier return to normal activities. However, sufficient evidence from well-designed studies is not yet available to establish whether this less invasive approach is as safe and effective as conventional surgery in patients who are not considered at high surgical risk. This study aims to address this evidence gap. \# WHO CAN JOIN THIS STUDY? Adults with severe aortic stenosis and significant coronary artery disease who have been assessed by a specialist heart team as having low or intermediate surgical risk may be eligible to participate. All participants must be considered suitable for both the catheter-based treatment approach and the surgical approach, based on individual coronary anatomy, clinical characteristics, and medical history. Patients with previous coronary artery bypass graft surgery, severely impaired left ventricular systolic function (ejection fraction below 40%), or a recent myocardial infarction within the previous 6 months are not eligible to participate. * WHAT WILL HAPPEN IF A PATIENT JOINS THE STUDY? Participants will receive one of two treatment approaches, selected by a specialist heart team according to individual coronary and valvular anatomy, clinical circumstances, and patient preference: 1. Catheter-based aortic valve replacement combined with coronary artery stenting (TAVI + PCI). 2. Conventional open-heart surgery involving surgical aortic valve replacement and coronary artery bypass grafting (SAVR + CABG). Regardless of the treatment received, all participants will undergo follow-up assessments at hospital discharge, 30 days, 6 months, and 1 year after the procedure. Follow-up will include clinical assessments and appropriate cardiac investigations. * WHAT IS THE STUDY MEASURING? The study will evaluate the incidence of major complications, including all-cause mortality, myocardial infarction, stroke, serious bleeding, and the need for urgent repeat intervention, during the index hospitalization and within 1 year after the procedure. Additional outcomes will include recovery duration, length of hospital stay, and changes in kidney function. * WHERE IS THE STUDY TAKING PLACE? The study is being conducted at Alexandria University Hospitals and other major cardiac centres across Egypt, with a planned total enrolment of 100 participants. \# WHO IS CONDUCTING THE STUDY? The study is being conducted by Dr. Moustafa AbdelMohsen Elsayed Madkour, Department of Cardiology and Angiology, Faculty of Medicine, Alexandria University, Egypt, under the supervision of Prof. Dr. Mohamed Ahmed Sobhy and Prof. Dr. Tarek Hussien Elzawawy.
Society of Thoracic Surgeons and American College of Cardiology Transcatheter Valve Therapy Registry (STS/ACC TVT Registry™): Registry Purpose and Research Objective
The STS/ACC TVT Registry™ (TVT Registry), created by The Society of Thoracic Surgeons (STS) and the American College of Cardiology Foundation (ACCF), is a benchmarking tool designed to assess the prevalence, demographics, management, and outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) procedure. Patient-level data will be submitted by participating hospitals to the TVT Registry via the American College of Cardiology Foundation's National Cardiovascular Data Registry (NCDR). The primary aims of the TVT Registry, are to optimize the outcomes and management of patients through the implementation of evidence-based guideline recommendations in clinical practice, facilitate efforts to improve the quality and safety for patients undergoing TAVR procedures, investigate novel quality improvement methods and provide risk-adjusted assessment of patients for comparison with nationwide NCDR data. The secondary purpose of the TVT Registry is to serve as a rich source of clinical data to support assessments of short- and long-term safety, comparative and cost effectiveness research, and as a scalable data infrastructure for pre and post market studies.
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