Key result
Transcatheter aortic valve implantation significantly reduced all-cause mortality compared to standard therapy in inoperable patients with severe aortic stenosis (HR 0.55).
Why the study?
Does transcatheter aortic valve implantation improve outcomes in high-risk patients with severe aortic stenosis compared to surgical aortic valve replacement or standard medical therapy?
Does transcatheter aortic valve implantation improve outcomes in high-risk patients with severe aortic stenosis compared to surgical aortic valve replacement or standard medical therapy?
Hazard Ratio: 0.55 (95% CI 0.4–0.74)
Absolute Event Rate: 30.7% vs 50.7%
Absolute Risk Reduction: 20%
p-value: p=<0.001
TAVI provides an effective, life-saving alternative for patients with severe aortic stenosis who are deemed inoperable or at high surgical risk.
Supports TAVI consideration in inoperable severe AS; leaves open durability and expansion questions for prospective trials.
Aortic stenosis (AS) has become an increasingly prevalent condition in ageing Western populations. Symptomatic AS is associated with significant morbidity, high hospitalisation rates and reduction in quality of life and life-expectancy. A large number of patients with severe AS are not currently receiving proper treatment, with subsequent increased mortality. While surgical aortic valve replacement continues to be an effective treatment for these patients, transcatheter aortic valve implantation is a new alternative for those at high risk from surgery. Overall, valve replacement and implantation procedures have a significant impact on prognosis and quality of life in AS patients. Referring a patient to a centre that has a multidisciplinary heart team will ensure that all treatment options are fully explored and the best clinical outcomes are reached.
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Fonseca et al. (2012) conducted a review in Severe aortic stenosis (n=358). Transcatheter aortic valve implantation (TAVI) vs. Standard medical therapy was evaluated on Death from any cause (HR 0.55, 95% CI 0.40-0.74, p=<0.001). Transcatheter aortic valve implantation significantly reduced all-cause mortality compared to standard therapy in inoperable patients with severe aortic stenosis (HR 0.55).
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