TAVR, SAVR linked to comparable long-term outcomes, new meta-analysis confirms
Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are associated with comparable long-term patient outcomes, according to a large meta-analysis presented at EuroPCR 2024 in Paris.
The findings were published simultaneously in JSCAI, the official journal of the Society for Cardiovascular Angiography and Interventions (SCAI).[1]
The study’s authors explored data from more than 7,500 patients who originally participated in one of seven different randomized controlled trials. All patients presented with severe aortic stenosis and underwent either TAVR (51.2%) or SAVR (48.8%). The mean follow-up period was nearly six years. The study included data from low-, intermediate- and high-risk patients, ensuring the findings covered a wide variety of cases.
Overall, the study revealed just how similar TAVR and SAVR are when examining patient outcomes. There was no significant difference in the long-term risk of death or disabling stroke between the two treatment strategies. This was true for all risk profiles.
TAVR, meanwhile, was linked to a higher risk of requiring a pacemaker or moderate-to-severe paravalvular leak. Again, these findings were true for all risk profiles.
“This study represents the largest scale analysis so far available comparing longer-term percutaneous devices for aortic valve replacement versus surgery,” co-author Eliano Pio Navarese, MD, PhD, head of clinical experimental cardiology and associate professor at the University of Sassari in Italy, said in an SCAI statement. “Our findings support the comparable long-term safety and efficacy of TAVR, as well as raise important considerations for valve type selection, particularly when we are dealing with longer-term valve durability and pacemaker implantation.”
Researchers also compared data from patients treated with self-expanding and balloon-expandable TAVR valves. While self-expanding TAVR was linked to a lower risk of death or stroke in addition to fewer cases of valve thrombosis. Pacemaker implantation rates, meanwhile, were higher after self-expanding TAVR than after balloon-expandable TAVR.
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.