Use of TAVR in low-risk patients

Editor's Note

In this study of low-risk patients with severe aortic stenosis, outcomes were significantly better at 1 year follow-up with transcatheter aortic-valve replacement (TAVR) than surgical aortic-valve replacement.

In 1,000 patients at 71 centers who were randomized to undergo either TAVR or surgical aortic-valve replacement, the rate of the primary endpoint (a composite of death, stroke, or rehospitalization) at 1 year was significantly lower in the TAVR group than the surgery group (8.5% vs 15.1%).

At 30 days, TAVR resulted in a lower rate of stroke than surgery and lower rates of death or stroke and new-onset atrial fibrillation. TAVR also resulted in a shorter index hospitalization than surgery and in a lower risk of a poor treatment outcomes at 30 days

The findings suggest that the value of TAVR compared with surgery may be independent of risk profiles, the researchers conclude. Current clinical practice restricts the use of TAVR in low-risk and younger patients, for whom surgery is standard therapy.