Key result
Transcatheter aortic valve replacement showed promising results for low-risk surgical patients with severe aortic stenosis in recent trials, though caveats to its use remain.
Why the study?
Recent trials showed promising results for TAVR in low-risk surgical patients with severe AS, but caveats remain regarding its use in clinical practice.
Does transcatheter aortic valve replacement (TAVR) improve safety and efficacy compared to surgical aortic valve replacement in patients with severe aortic stenosis at low risk for surgery?
Does transcatheter aortic valve replacement (TAVR) improve safety and efficacy compared to surgical aortic valve replacement in patients with severe aortic stenosis at low risk for surgery?
Recent trials show promising results for TAVR in low-risk severe aortic stenosis patients, though caveats remain for its use in routine clinical practice.
Answers are grounded in this paper and cite their sources.
Caution warranted before routine TAVR adoption in low-risk severe AS; leaves open durability and selection criteria for practice.
New trials, PARTNER 3 and Evolut Low Risk, showed promising results for transcatheter aortic valve replacement for low-risk surgical patients with severe aortic stenosis. However, there remain caveats to its use in this population in clinical practice. Aortic stenosis (AS) is the most common valve disease in developed countries.1 In the absence of valve replacement, severe AS has a 2-year mortality rate of more than 50%.2 Historically, surgery was the predominant treatment option for severe AS. However, two recent randomised controlled trials have further examined the use of a minimally invasive approach: transcatheter aortic valve replacement (TAVR). PARTNER 33 and Evolut Low Risk4 examined the safety and efficacy of TAVR in patients with severe AS at low risk for surgical AVR (SAVR). Patients having open operations can be categorised into low, intermediate and high risk for perioperative mortality using a validated risk-prediction model called the Society of Thoracic Surgery (STS) score.5 PARTNER 3 randomised …
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Harvey et al. (2019) conducted an editorial in Severe aortic stenosis. Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated. Transcatheter aortic valve replacement showed promising results for low-risk surgical patients with severe aortic stenosis in recent trials, though caveats to its use remain.
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