How Does TAVR Fare in Intermediate-Risk Patients?

Transcatheter aortic valve replacement (TAVR) is a valuable alternative to surgical aortic valve replacement (SAVR) in high-risk patients with severe aortic stenosis (NEJM JW Cardiol May 2015 and Lancet 2015; 385:2485). In a multicenter, randomized trial funded by the TAVR system's manufacturer, researchers have now compared TAVR with SAVR in 2032 patients (mean age, 82 years; 46% women) with severe aortic stenosis who were designated as “intermediate-risk” but still were in the highest-risk quintile for surgery (mean Society of Thoracic Surgeons score, 5.8%).

At 2 years, the overall rate of death or disabling stroke was similar in the TAVR and SAVR groups (19.3% and 21.1%, respectively). This statistical similarity between the two approache…