October 15, 2014Interactive Cardiovascular and Thoracic Surgery
Treating the patients in the ‘grey-zone’ with aortic valve disease: a comparison among conventional surgery, sutureless valves and transcatheter aortic valve replacement
Key result
TAVR was associated with lower 24-month survival free from MACCE and prosthetic regurgitation compared to sAVR and sutureless valves (70.5% vs 95.2% and 91.6%; P=0.015).
Why the study?
Does TAVR or sutureless valve implantation improve outcomes compared to conventional surgery in intermediate- to high-risk patients with aortic valve disease?
Study Design
Type
Cohort (n=163)
Structured PICO
Does TAVR or sutureless valve implantation improve outcomes compared to conventional surgery in intermediate- to high-risk patients with aortic valve disease?
P
Population
163 consecutive patients with intermediate- to high-risk aortic valve disease undergoing conventional surgery, sutureless valve implantation, or TAVR, followed for 24 months.
E
Exposure
Transcatheter aortic valve replacement (TAVR) with Corevalve prosthesis (n=55) or sutureless valve implantation with Perceval S (n=53)
C
Comparator
Conventional surgical aortic valve replacement (sAVR) (n=55)
O
Outcome
Overall survival free from major adverse cardiac and cerebrovascular events and prosthetic regurgitation at 24-month follow-upcomposite
Main Result
Absolute Event Rate: 70.5% vs 95.2%
p-value: p=0.015
In intermediate- to high-risk patients with aortic valve disease, TAVR was associated with higher perioperative complications and decreased 24-month survival free from MACCE and regurgitation compared to conventional surgery or sutureless valves.
Limitations
- Preliminary study
Authors
Discussion
No takes yet. Share an insight, caveat, or question.
Implication
May warrant caution with TAVR in intermediate- to high-risk patients; leaves open need for randomized trials to guide valve selection.
Cite This Study
Muneretto et al. (2014) conducted a cohort in aortic valve disease (n=163). Transcatheter aortic valve replacement (TAVR) vs. Conventional surgery (sAVR) or sutureless valves was evaluated on Overall survival free from major adverse cardiac and cerebrovascular events and prosthetic regurgitation (p=0.015). TAVR was associated with lower 24-month survival free from MACCE and prosthetic regurgitation compared to sAVR and sutureless valves (70.5% vs 95.2% and 91.6%; P=0.015).