TCT: TAVR, SAVR Comparable for Severe Aortic Stenosis, Small Aortic Annulus

By Elana Gotkine HealthDay Reporter

FRIDAY, Oct. 27, 2023 — For patients with severe aortic stenosis (AS) and small aortic annulus (SAA), valve hemodynamic results are comparable with use of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR), according to a study published online Oct. 26 in Circulation to coincide with the annual Transcatheter Cardiovascular Therapeutics conference, held from Oct. 23 to 26 in San Francisco.

Josep Rodés-Cabau, M.D., Ph.D., from Quebec Heart and Lung Institute in Canada, and colleagues compared the hemodynamic and clinical outcomes between TAVR and SAVR in a prospective multicenter international randomized trial performed in 15 hospitals. A total of 151 patients (93 percent women) with severe AS and SAA (mean diameter, <23 mm) were randomly assigned to TAVR and SAVR (77 and 74, respectively).

The researchers observed no between-group differences in the rate of severe prosthesis patient mismatch (5.6 and 10.3 percent, respectively) or moderate-severe aortic regurgitation (none in either group). The groups did not differ significantly in terms of mortality (1.3 and 1.4 percent, respectively) or stroke (0 and 2.7 percent, respectively) at 30 days. No significant differences were seen between the groups regarding mortality, stroke, or cardiac hospitalization after a median follow-up of two years.

“The results of this trial suggest that these two therapies represent a valid alternative for treating patients with SA and SAA, and treatment selection should likely be individualized according to baseline characteristics, additional anatomical risk factors, and patient preference,” the authors write.

Several authors disclosed ties to the biopharmaceutical and medical device industries.

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