Home > Journal Club > Journal Club 22 July 2015

Journal Club 22 July 2015

Paper

2-Year Outcomes in Patients Undergoing Surgical or Self-Expanding Transcatheter Aortic Valve Replacement

Presenter

AB

Summary

BACKGROUND

The U.S. pivotal trial for the self-expanding valve found that among patients with severe aortic stenosis
at increased risk for surgery, the 1-year survival rate was 4.9 percentage points higher in patients treated with a selfexpanding
transcatheter aortic valve bioprosthesis than in those treated with a surgical bioprosthesis.

OBJECTIVES

Longer-term clinical outcomes were examined to confirm if this mortality benefit is sustained.
METHODS Patients with severe aortic stenosis who were at increased surgical risk were recruited. Eligible patients were randomly assigned in a 1:1 ratio to transcatheter aortic valve replacement with the self-expanding transcatheter valve (transcatheter aortic valve replacement [TAVR] group) or to aortic valve replacement with a surgical bioprosthesis (surgical group). The 2-year clinical and echocardiographic outcomes were evaluated in these patients.

RESULTS

A total of 797 patients underwent randomization at 45 centers in the United States. The rate of 2-year all-cause mortality was significantly lower in the TAVR group (22.2%) than in the surgical group (28.6%; log-rank test p < 0.05) in the as-treated cohort, with an absolute reduction in risk of 6.5 percentage points. Similar results were found in the intention-to-treat cohort (log-rank test p < 0.05). The rate of 2-year death or major stroke was significantly
lower in the TAVR group (24.2%) than in the surgical group (32.5%; log-rank test p ¼ 0.01).

CONCLUSIONS

In patients with severe aortic stenosis who are at increased surgical risk, the higher rate of survival with a self-expanding TAVR compared with surgery was sustained at 2 years.

Advertisements
Categories: Journal Club
  1. No comments yet.
  1. No trackbacks yet.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: