Key result
TAVR matches SAVR for early mortality and disabling stroke in low-risk patients, but varies by anatomy.
Why the study?
Does transcatheter aortic valve replacement (TAVR) reduce mortality and disabling stroke compared to surgical aortic valve replacement (SAVR) in low-risk patients with severe symptomatic aortic stenosis?
Does transcatheter aortic valve replacement (TAVR) reduce mortality and disabling stroke compared to surgical aortic valve replacement (SAVR) in low-risk patients with severe symptomatic aortic stenosis?
TAVR is at least as effective as SAVR in low-risk patients with severe aortic stenosis, but anatomical variations like bicuspid valves require a personalized Heart Team approach.
Requires anatomy-informed shared decisions for low-risk TAVR/SAVR; extends RCT data by identifying selection and bicuspid impacts.
The low-risk TAVR vs SAVR RCTs - PARTNER-3, Evolut Low-Risk, DEDICATE, and NOTION-2 - demonstrate that TAVR is at least as effective as SAVR in terms of early mortality and disabling stroke, although outcomes varied across studies. The excellent outcomes observed in the PARTNER-3 trial reflect the highly selected patient population, while the NOTION-2 trial highlights the challenges posed by anatomical variations, such as bicuspid aortic valves (AV). These findings highlight the importance of a personalized approach guided by a multidisciplinary Heart Team, taking into account both clinical and anatomical aspects when choosing between TAVR and SAVR. Trial registration number: ClinicalTrials.gov NCT02825134.
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Jørgensen et al. (2025) conducted a review in Severe symptomatic aortic stenosis. Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on Composite of all-cause mortality and disabling stroke. TAVR is at least as effective as SAVR for early mortality and disabling stroke in low-risk patients, though outcomes vary based on anatomical variations such as bicuspid aortic valves.
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