Study: TAVR equal to or better than surgery

Editor's Note

This study comparing transcatheter aortic valve replacement (TAVR) with standard open-heart surgery found no difference in stroke or death from any cause at 2 years follow-up. The findings were presented March 17 at the American College of Cardiology’s Annual Scientific Session in New Orleans.

A total of 1,468 patients with severe, symptomatic aortic stenosis from 86 centers world wide were included in the study, with 725 patients receiving TAVR and 678 patients having open surgical aortic valve replacement. Two-thirds of the patients were men and one-third women.

At 30 days, TAVR was statistically superior for all-cause mortality or disabling stroke (0.8% vs 2.6%). Deaths occurred in 1.3% of surgical patients and 0.5% of TAVR patients, and TAVR patients had significantly better quality of life and hemodynamics. Hospital stays were 2.6 days for TAVR patients and 6.2 days for open patients.

At 2-years follow-up, TAVR and open aortic valve replacement composite endpoints of death or disabling stroke were similar (TAVR, 5.3% and open, 6.7%).

The findings suggest that it is reasonable to consider moving TAVR in low-risk patients to a Class I guideline indication on par with surgery for severe aortic stenosis, the researchers say.