Surgical risk scores may not be needed when considering TAVR
Clinicians may not necessarily need to assess a patient’s surgical risk when determining if they are a suitable candidate for transcatheter aortic valve replacement (TAVR), according to a new study published in Current Problems in Cardiology. Instead, that time could be spent focusing on other important considerations such as the patient’s life expectancy.
TAVR, the authors explained, was first implemented as an alternative to surgical aortic valve replacement (SAVR) for patients who were at a heightened risk of surgical complications. Now, however, multiple studies have found that TAVR is non-inferior—and even superior—to SAVR for a wide range of patient populations. Why focus on their surgical risk at all?
Researchers examined data from eight randomized clinical trials. Overall, they found “no detectable correlation or association” between a patient’s Society of Thoracic Surgeons (STS) risk score and their TAVR outcome in terms of either mortality or stroke.
“Our results suggest that TAVR is a superior treatment for both mortality and stroke than SAVR,” wrote lead author Rocio Baro, of Instituto Cardiovascular de Buenos Aires in Argentina, and colleagues. “Using the best available evidence, we did not detect an association between clinical benefit of TAVR and surgical risk, suggesting that we should reconsider the usefulness of surgical risk scoring for predicting TAVR benefit in patients with severe aortic stenosis.”
Baro et al. also emphasized that “the main unknown” right now regarding TAVR is its long-term durability. If this is the case, they wrote, factors such as patient age and life expectancy appear to be much more vital than assessing a patient’s STS risk score.
Click here to read the full analysis in Current Problems in Cardiology.
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.