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
Complete ultrasound scans before and after valve replacement
This prospective, single-center observational study aims to evaluate the relationship between changes in aortic valve hemodynamics and pulmonary congestion in patients undergoing elective transfemoral transcatheter aortic valve implantation (TAVI) for severe symptomatic aortic stenosis. Pulmonary congestion will be assessed non-invasively using lung ultrasound, with particular emphasis on B-lines, at predefined time points before and after TAVI. Changes in aortic valve area and other echocardiographic parameters will be evaluated in relation to changes in lung ultrasound findings. The primary objective is to determine the association between improvement in aortic valve area following TAVI and changes in pulmonary congestion.
Complete imaging scans to screen for a heart protein disease
Degenerative aortic stenosis (AS) is frequently accompanied by left ventricular hypertrophy and diastolic dysfunction, features that overlap with transthyretin (ATTR) cardiac amyloidosis. Because concomitant cardiac amyloidosis may adversely affect outcomes after transcatheter aortic valve implantation (TAVI), its early detection is clinically important. This prospective observational study aims to evaluate multimodal imaging biomarkers for the detection and characterization of cardiac amyloidosis in patients with severe AS undergoing TAVI evaluation. Clinically indicated technetium-99m phosphonate SPECT/CT and CT will be used to assess the presence and extent of cardiac amyloidosis, including quantitative measures of myocardial tracer uptake and extracellular volume. In patients with abnormal findings, cardiac magnetic resonance imaging (CMR) will be performed as an additional non-invasive imaging modality according to institutional clinical practice. The study will determine the prevalence of cardiac amyloidosis in this population and investigate the diagnostic and prognostic value of imaging-derived quantitative parameters. Standardized clinical follow-up at 6, 12, and 24 months will assess associations between imaging biomarkers and clinical outcomes. The study is observational and does not alter routine clinical management or diagnostic pathways.
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