Key result
TAVR may offer better short-term outcomes but similar or worse long-term survival vs. SAVR in dialysis.
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Why the study?
Comparative durability and risk of structural valve deterioration between transcatheter and surgical bioprosthetic valves in dialysis patients remain poorly defined.
What are the comparative durability, risks of structural valve deterioration, and clinical outcomes of TAVR versus SAVR in dialysis patients with severe aortic stenosis?
What are the comparative durability, risks of structural valve deterioration, and clinical outcomes of TAVR versus SAVR in dialysis patients with severe aortic stenosis?
This review emphasizes the importance of evaluating valve durability and planning lifelong management strategies, including reintervention, when treating severe aortic stenosis in patients on dialysis.
Previous reports have comprehensively assessed clinical outcomes of transcatheter (TAVR) and surgical aortic valve replacement (SAVR) in patients with chronic kidney disease (CKD), including those on dialysis. Some studies suggest better short-term outcomes with TAVR, including lower periprocedural mortality, acute-on-chronic kidney injury, bleeding, and shorter length of stay, but similar or worse long-term survival compared with SAVR. While clinical outcomes have been studied, comparative durability and risk of structural valve deterioration (SVD) between transcatheter and surgical bioprosthetic valves in dialysis patients remain poorly defined. The therapeutic approach for the treatment of aortic valve disease in patients with end-stage renal disease is clinically relevant as these patients have short life expectancy and often receive bioprosthetic valves that are at higher risk for accelerated SVD and failure. This review synthesizes current literature describing TAVR and SAVR valve durability in patients with end-stage renal disease, focusing on mechanisms of bioprosthetic SVD, outcomes associated with TAVR and SAVR, and explores strategies for lifelong management of aortic valve disease, including considerations for reintervention.
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Moos et al. (2026) conducted a review in Severe aortic stenosis in dialysis patients. Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated. Transcatheter aortic valve replacement may offer better short-term outcomes but similar or worse long-term survival compared to surgical replacement in dialysis patients with severe aortic stenosis.
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