TAVR Does Not Significantly Reduce Mortality Compared With Surgery

Data presented at the AHA 2017 Scientific Sessions found that all-cause mortality among patients undergoing transcatheter aortic valve replacement (TAVR) was not significantly different compared with patients undergoing surgical aortic valve replacement (SAVR).

“The comparative benefits and harms of TAVR intervention and SAVR for high surgical risk patients with aortic stenosis haven’t shown any significant statistical and clinical difference up to 2 years,” Garly Rushler Saint Croix, MD, of Jackson Memorial Hospital, and colleagues wrote in the study abstract. “However, the comparison has not been well characterized beyond 3 years.”

To compare the outcomes of TAVR and SAVR in high surgical risk patients with at least 3 years of follow up, the researchers conducted a meta-analysis of three relevant randomized controlled trials with a total of 6321 study participants. They combed through studied from between 2000 to 2017. 

Study results showed that there was no significant difference between the two interventions—with stroke rates statistically similar in both groups. However, the researchers did find a higher rate of pacemaker implantation among patient who received TAVR.

“This study confirms that all-cause mortality beyond 3 and up to 5 years in TAVR vs SAVR is not statistically significant,” Dr Rushler Saint Croix and colleagues concluded. “There is no difference in incidence of stroke either. However, there appears to have an increased risk of pacemaker placement in high-risk patients undergoing TAVR compared to SAVR.”

—David Costill