TAVR outperforms surgery for low-risk patients after 2 years—but the gap may be shrinking
Transcatheter aortic valve replacement (TAVR) is still associated with better outcomes for low-risk patients than surgery after two years, according to an updated analysis of the PARTNER 3 trial.
However, the authors wrote, some data suggest the difference in performance between TAVR and surgical aortic valve replacement (SAVR) may not be quite as significant as it was after one year.
This latest study, published in the Journal of the American College of Cardiology, focused on findings from 1,000 patients who either underwent TAVR with the Sapien 3 valve or SAVR. A thorough follow-up occurred after 30 days, one year and two years.
Overall, after two years, TAVR was linked to a reduction in the study’s primary endpoint—a composite of all-cause mortality, stroke and cardiovascular rehospitalization. That endpoint was reached by 11.5% of TAVR patients and 17.4% of SAVR patients.
On the other hand, some perceived advantages of TAVR seemed to be less prevalent in this latest analysis than after one year. For instance, the differences in death and stroke between TAVR and SAVR that were present after one year “were not statistically significant” after two years.
Also, the authors noted, valve thrombosis was more common after two years among TAVR patients (2.6%) than SAVR patients (0.7%). Imaging findings were similar between the two treatment options.
The PARTNER 3 trial is scheduled to provide follow-up information on study participants for a total of 10 years, a sign that this is far from the last word on the topic. The authors emphasized that it is too early to make any definitive statements about the value of TAVR versus SAVR for low-risk patients.
“Longer-term follow-up is needed to determine the value of TAVR as an alternative to surgery in patients with aortic stenosis,” wrote lead author Martin B. Leon, MD, of Columbia University Irving Medical Center/NewYork Presbyterian Hospital in New York City, and colleagues.
The full study is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.