Is Transcatheter Aortic Valve Replacement for Low-Risk Patients Ready for Prime Time?

Not yet, but an observational study suggests excellent short-term outcomes for a highly selected cohort.

Transcatheter aortic valve replacement (TAVR) is an approved therapy for patients with severe symptomatic aortic stenosis and either high or intermediate surgical risk. With increasing experience and procedural success, there is growing interest in applying this approach to patients at low surgical risk as well. In a single-arm, multicenter study (NCT02628899), investigators treated 200 selected patients who had severe aortic stenosis, confirmed low surgical risk (predicted 30-day surgical mortality, ≤3%), and anatomic suitability for transfemoral TAVR with balloon-expandable or self-expanding valves.

All patients underwent attempted TAVR with a high rate of procedural success. Outcomes were compared with a historical cohort of 719 low-risk …

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)