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Until recently, transcatheter aortic valve replacement (TAVR) was reserved for patients in whom conventional valve replacement was considered to be too high risk. But in 2019, two studies shed light on outcomes with TAVR in low-risk patients.
In the one study, 1000 patients at low surgical risk were randomized to surgical aortic valve replacement (SAVR) or TAVR. Death, stroke, or rehospitalization at 1 year was significantly lower in the TAVR group (8.5% vs 15.1%). TAVR also conferred lower 30-day rates of death, stroke, and new atrial fibrillation and was associated with shorter index hospitalization, although new left bundle branch block and paravalvular regurgitation were more common with TAVR (NEJM JW Gen Med May 1 2019 and N Engl J Med …