5-Year Outcomes of TAVR vs. Surgery in Low-Risk Patients

A randomized study demonstrated similar rates of death and stroke with the two interventions.

Transcatheter aortic valve replacement (TAVR) has become the leading treatment for patients with severe, symptomatic aortic stenosis (AS). However, there are limited long-term data on how this procedure compares with surgery, particularly in patients at low risk for surgical AVR.

In this manufacturer-funded, randomized trial, 1414 patients underwent TAVR with a self-expanding supra-annular valve or surgery (NCT02701283). Inclusion criteria included a low predicted risk of death (<3%; mean, 1.9%); the mean age of patients was 74 years. About 90% of participants were available for 5-year follow-up.

The primary endpoint of death or disabling stroke was similar with TAVR (15.5%) and surgery (16.4%). Pacemaker implants and mild paravalvular leaks …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)