Surgical aortic valve replacement (SAVR) is associated with “excellent” long-term survival rates among low-risk patients, according to a new analysis published in The Annals of Thoracic Surgery.[1]
Even as transcatheter aortic valve replacement (TAVR) continues to build momentum as the go-to treatment options for many patients presenting with severe symptomatic aortic stenosis, researchers are keeping a close eye on the long-term safety and effectiveness of SAVR.
“There remains absolutely no doubt that TAVR is an excellent primary option for patients of higher risk or advanced age,” senior author Vinay Badhwar, MD, chair of the department of cardiovascular and thoracic surgery at West Virginia University (WVU) and executive chair of the WVU Heart and Vascular Institute, said in a prepared statement from The Society of Thoracic Surgeons (STS). “The aim of this study was to specifically evaluate patients of low risk, and this revealed that longitudinal outcomes of SAVR in this specific population are outstanding. As surgeons are consistently performing these surgeries with excellent outcomes, and now in minimally invasive fashion, these data should give providers of valve therapy, including cardiologists and surgeons, a point of reflection when it comes to deciding what the best option is for their patients.”
Badhwar et al. explored data from The Society of Thoracic Surgeons National Database, which includes approximately 97% of all cardiac procedures performed in the United States. The group focused on low-risk SAVR patients treated from 2011 to 2019. The mean patient age was 74.3 years old, and the mean STS predicted risk of mortality (STS PROM) was 1.9%.
Overall, the survival rate was 92.9% after five years and 87% after eight years. As one might expect, survival rates were “significantly better” for younger low-risk SAVR patients than it was among older patients.
Among only patients with an STS PROM below 1%, the survival rate after eight years was 95%.
“This study sets a benchmark for outcomes for management of aortic valve stenosis,” first author Vinod Thourani, MD, chair of cardiovascular surgery at the Piedmont Heart Institute in Atlanta, said in the same statement. “This analysis is significant because of the longitudinal follow-up with very large numbers of patients, and it is an important complement to results from randomized clinical trials that are commonly measured over just one year.”
Click here to read the full study in The Annals of Thoracic Surgery.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.