Survival rates similar for TAVR, surgical AVR in low-risk patients
Patients with aortic stenosis who were at low risk and underwent transcatheter aortic valve replacement had similar short-term and midterm survival rates compared with those who underwent surgical AVR, according to a study published in JAMA Network Open.
Marko P.O. Virtanen, MD, of the Heart Hospital at Tampere University Hospital in Finland, and colleagues analyzed data from 2,841 patients (mean age, 74 years; 55% men) with aortic stenosis and were at low risk who underwent TAVR (n = 325) or surgical AVR (n = 2,516) between January 2008 to November 2017. Operative risk was calculated with the Society of Thoracic Surgeons Predicted Risk of Mortality (PROM) and the updated European System for Cardiac Operative Risk Evaluation (EuroSCORE II) scores.
Researchers also propensity-score matched 304 pairs with similar baseline characteristics.
The primary outcome of interest was survival at 30 days and 3 years. Follow-up was conducted for a mean of 4 years.
Third-generation devices were used in 49.3% of patients who underwent surgical AVR and 86.5% of those who underwent TAVR.
In the pairs who were propensity matched, 30-day mortality occurred in 3.6% of patients in the surgical AVR group and 1.3% of those in the TAVR group (P = .12). Both groups had similar rates of 3-year survival (87.7% for surgical AVR vs. 85.7% for TAVR; P = .45).
Survival from TAVR vs. surgical AVR was similar when comparing patients younger than 80 years with those older than 80 years based on interaction tests (P for interaction = .23). The survival rate among both procedures was also similar when comparing patients who received selected valve protheses vs. those who did not (P for interaction = .26).
“Before extending the use of TAVR to low-risk patients, further studies are needed to assess the long-term durability of transcatheter aortic valve prostheses,” Virtanen and colleagues wrote. – by Darlene Dobkowski
Disclosures: Virtanen reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.