Heart surgery outperforms TAVR in new 5-year study of young, low-risk patients
Surgical aortic valve replacement (SAVR) may be a more effective treatment option than transcatheter aortic valve replacement (TAVR) for patients between the ages of 50 and 65 years old, according to new findings published in The Annals of Thoracic Surgery.[1]
Care teams are turning to TAVR more and more when treating severe aortic stenosis, a trend that shows no signs of slowing down as time goes on. Clinical guidelines still largely recommend SAVR for younger patients, however, primarily due to the risk of follow-up interventions being needed later in life.
For this latest study, researchers tracked real-world data from more than 37,000 patients treated with TAVR or SAVR from 2016 to 2024. Their clone-sensor-weighted analysis focused on 18.549 TAVR patients and 18,549 SAVR patients. The mean age was 60 years old. Low-risk patients made up 69.5% of those treated with SAVR and 49.7% of those treated with TAVR.
TAVR and SAVR were both linked to low rates of in-hospital mortality and periprocedural stroke, though TAVR did outperform SAVR when it came to both outcomes. After five years, on the other hand, the study’s primary outcome—freedom from all-cause mortality, stroke, valve reintervention and heart failure rehospitalization—was seen in 87.5% of SAVR patients compared to 77.8% of TAVR patients. The five-year rates of heart failure rehospitalization and all-cause mortality were also significantly lower after SAVR than they were after TAVR.
“Given current practice trends toward TAVR in younger patients beyond the bounds of existing evidence and guidelines, these results should inform heart teams counseling younger patients on optimal therapy for aortic stenosis,” wrote first author J. Hunter Mehaffey, MD, MSc, an assistant professor and co-director of research in the division of cardiac surgery with West Virginia University, and colleagues.
One key takeaway was the fact that patients treated at facilities more experienced in performing TAVR were actually linked to an increased risk of poor outcomes.
“One would expect outcomes to improve as the frequency of a procedure increases within a population, particularly when results depend on operator experience,” the authors wrote. “Instead, these data illustrate that outcome differences may relate to application of the procedure itself.”
Click here to read the full study.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.