Why the study?
The treatment of aortic stenosis is rapidly evolving with differing paces of change between TAVR and SAVR, prompting evaluation of temporal changes in 30-day outcomes between procedures.
Does TAVR improve 30-day mortality compared to SAVR in US Medicare patients aged ≥65 years?
Population
245 269 SAVR and 188 580 TAVR US Medicare patients aged ≥65 years
Comparison
TAVR vs SAVR across index years (2012 to 2019)
Design
Retrospective cohort study
Follow-up
30 days
Key result
TAVR was associated with lower 30-day mortality compared with SAVR, with the mortality benefit increasing until 2016 (HR 0.39; 95% CI 0.36-0.43) and attenuating from 2017 to 2019.
Authors
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Temporal improvements in TAVR outcomes outpaced SAVR until 2016 with possible narrowing gap; leaves open questions on sustained trends and optimal case selection.
Cohort (n=433,849)
Yes
Does TAVR improve 30-day mortality compared to SAVR in US Medicare patients aged ≥65 years?
Hazard Ratio: 0.39 (95% CI 0.36–0.43)
While TAVR consistently demonstrated lower 30-day mortality and readmission rates than SAVR in Medicare patients from 2012 to 2019, the magnitude of this benefit peaked in 2016 and has since narrowed.
Lauck et al. (2021) conducted a cohort in Aortic stenosis (n=433,849). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on 30-day mortality (HR 0.39, 95% CI 0.36-0.43). TAVR was associated with lower 30-day mortality compared with SAVR, with the mortality benefit increasing until 2016 (HR 0.39; 95% CI 0.36-0.43) and attenuating from 2017 to 2019.