• Aortic Valve Stenosis
• Transcatheter Aortic Valve Replacement
• Heart Valve Prosthesis Implantation

In the 22 years since Professor Alain Cribier performed the first transcatheter aortic valve implantation (TAVI) in Rouen in France, treatment pathways for patients with aortic valve stenosis have evolved rapidly. The availability of TAVI has increased as expertise and the number of operators have grown, alongside significant improvements to transcatheter valves and delivery devices, prerequisite cross-sectional imaging, procedural approaches and care pathways. Indeed, in international guidelines, TAVI is now given a Class IA recommendation as the mode of intervention for patients greater than or equal to 75 years of age, or those at high risk or unsuitable for surgery.1 However, treatment decisions and access to novel modes of intervention around the world vary, being influenced by health policy, funding and social determinants of health.2 While the overall number of patients undergoing aortic valve replacement has increased in the UK, it remains unclear whether increased intervention rates are observed evenly across the two sexes and across different ethnicities and how transcatheter versus surgical intervention rates vary across these groups.

It is in this context that Singh et al report sociodemographic variations in treatment trends and outcomes of surgical …