Key result
TAVI in very severe AS shows similar 1-year major event rates compared to severe AS.
Why the study?
Very severe aortic stenosis has a poor prognosis, but the safety and effectiveness of TAVI in this population are not well-established.
Does transcatheter aortic valve implantation (TAVI) yield comparable clinical outcomes in patients with very severe aortic stenosis compared to those with severe aortic stenosis?
Cohort (n=366)
No
Does transcatheter aortic valve implantation (TAVI) yield comparable clinical outcomes in patients with very severe aortic stenosis compared to those with severe aortic stenosis?
TAVI is a feasible and safe treatment option for patients with very severe aortic stenosis, demonstrating comparable 1-year clinical outcomes to those with severe aortic stenosis despite a higher rate of prosthesis-patient mismatch.
Answers are grounded in this paper and cite their sources.
Supports TAVI consideration in very severe AS; leaves open need for randomized confirmation.
Background: Very severe aortic stenosis (AS) has a poor prognosis even in asymptomatic patients, and asymptomatic very severe AS is a Class IIa indication for aortic valve replacement, although the safety and effectiveness of transcatheter aortic valve implantation (TAVI) for very severe AS is not well-established.
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Kobayashi et al. (2023) conducted a cohort in Aortic stenosis (n=366). Very severe aortic stenosis vs. Severe aortic stenosis was evaluated on Composite of all-cause mortality, disabling stroke, rehospitalization of heart failure, and major bleeding at 1 year (HR 0.76, 95% CI 0.41-1.39, p=0.365). In patients undergoing transcatheter aortic valve implantation, very severe aortic stenosis was associated with a similar 1-year rate of the primary composite endpoint compared to severe aortic stenosis.
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