WASHINGTON — The course of disease is not always taken into account as a novel technology enters routine use, but Michael Mack, the famed cardiac surgeon from Baylor Heart Center (Dallas), suggested that one way to minimize the number of surgeries for a 40-year old patient would be to start with a transcatheter aortic valve replacement (TAVR) because the expected life of these devices and the prospects for valve-in-valve placement could get this patient into his or her 80s with only one conventional surgical intervention.
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