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BALTIMORE – A study comparing the causes and timing of death in high-risk patients with severe, symptomatic aortic stenosis suggests that transcatheter aortic valve replacement (TAVR) may have significant advantages over surgical aortic valve replacement (SAVR).
The research team, presenting their findings at the annual meeting of the American Association for Thoracic Surgery, revealed that death rates in the TAVR and SAVR cohorts in the CoreValve US Pivotal Trial High Risk Study were similar at 0-30 days and 91-365 days post procedure, but found that more SAVR patients died from day 31-90 related to bleeding, frailty, and comorbid diseases. The investigators concluded that this finding reflected the impact of the added strain of surgery over intravascular intervention for aortic valve replacement.
Dr. Craig Smith, chair of the department of surgery at NewYork–Presbyterian Hospital/Columbia University Medical Center, and a discussant on the paper, said this study is the only randomized clinical trial to show inferiority of surgery to TAVR.
“The difference seems to reside in the recovery phase mortality, which they showed very well,” Dr. Smith said in a video interview. He predicted that the trial results would add to the momentum making TAVR the first choice for any patient who is high risk and at least an equivalent choice for patients who are considered intermediate risk.
“The big question on the horizon is what is the best thing to recommend to patients who we classify as low risk,” Dr. Smith said. “Unless something happens to the impressive results that TAVR is racking up, in a few years … approval will be granted for those who are low risk.”
Dr. Smith reported no relevant financial disclosures.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @richpizzi
BALTIMORE – A study comparing the causes and timing of death in high-risk patients with severe, symptomatic aortic stenosis suggests that transcatheter aortic valve replacement (TAVR) may have significant advantages over surgical aortic valve replacement (SAVR).
The research team, presenting their findings at the annual meeting of the American Association for Thoracic Surgery, revealed that death rates in the TAVR and SAVR cohorts in the CoreValve US Pivotal Trial High Risk Study were similar at 0-30 days and 91-365 days post procedure, but found that more SAVR patients died from day 31-90 related to bleeding, frailty, and comorbid diseases. The investigators concluded that this finding reflected the impact of the added strain of surgery over intravascular intervention for aortic valve replacement.
Dr. Craig Smith, chair of the department of surgery at NewYork–Presbyterian Hospital/Columbia University Medical Center, and a discussant on the paper, said this study is the only randomized clinical trial to show inferiority of surgery to TAVR.
“The difference seems to reside in the recovery phase mortality, which they showed very well,” Dr. Smith said in a video interview. He predicted that the trial results would add to the momentum making TAVR the first choice for any patient who is high risk and at least an equivalent choice for patients who are considered intermediate risk.
“The big question on the horizon is what is the best thing to recommend to patients who we classify as low risk,” Dr. Smith said. “Unless something happens to the impressive results that TAVR is racking up, in a few years … approval will be granted for those who are low risk.”
Dr. Smith reported no relevant financial disclosures.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @richpizzi
BALTIMORE – A study comparing the causes and timing of death in high-risk patients with severe, symptomatic aortic stenosis suggests that transcatheter aortic valve replacement (TAVR) may have significant advantages over surgical aortic valve replacement (SAVR).
The research team, presenting their findings at the annual meeting of the American Association for Thoracic Surgery, revealed that death rates in the TAVR and SAVR cohorts in the CoreValve US Pivotal Trial High Risk Study were similar at 0-30 days and 91-365 days post procedure, but found that more SAVR patients died from day 31-90 related to bleeding, frailty, and comorbid diseases. The investigators concluded that this finding reflected the impact of the added strain of surgery over intravascular intervention for aortic valve replacement.
Dr. Craig Smith, chair of the department of surgery at NewYork–Presbyterian Hospital/Columbia University Medical Center, and a discussant on the paper, said this study is the only randomized clinical trial to show inferiority of surgery to TAVR.
“The difference seems to reside in the recovery phase mortality, which they showed very well,” Dr. Smith said in a video interview. He predicted that the trial results would add to the momentum making TAVR the first choice for any patient who is high risk and at least an equivalent choice for patients who are considered intermediate risk.
“The big question on the horizon is what is the best thing to recommend to patients who we classify as low risk,” Dr. Smith said. “Unless something happens to the impressive results that TAVR is racking up, in a few years … approval will be granted for those who are low risk.”
Dr. Smith reported no relevant financial disclosures.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @richpizzi
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