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Long-Term Outcomes of Transcatheter Aortic Valve Replacement 

5 May, 15 | by Alistair Lindsay

The Placement of Aortic Transcatheter Valves (PARTNER) trial demonstrated that transcatheter aortic valve replacement (TAVR) for high-risk patients with aortic stenosis resulted in similar outcomes at 1, 2 and 3 years compared with surgical aortic valve replacement (SAVR). The present study reports the 5-year outcomes of this trial. The study enrolled 699 patients who were randomized to SAVR or TAVR (via a transfemoral or transapical approach). Overall, mean age was 84.1 years, 94% were NYHA Class 3 or 4, and the mean Society of Thoracic Surgeons Predicted Risk of Mortality at 30 days was 11.8%. At 5 years, there were no significant differences in mortality between groups (67.8% in the TAVR group versus 62.4% in the SAVR group; hazard ratio 1.04, 95% CI 0.86–1.24; p=0.76). more…

Clinical Outcomes at 1 Year Following Transcatheter Aortic Valve Replacement  

16 Apr, 15 | by Alistair Lindsay

To date, long-term outcome data following transcatheter aortic valve replacement (TAVR) has only been available from clinical trial data.  Evaluating long-term outcomes of TAVR in real-world use is important to ensure the anticipated benefits are observed in routine clinical practice.  Using data from the Society of Thoracic Surgeons/American College of Cardiology (STS/ACC) Transcatheter Valve therapies registry merged with Centers for Medicare & Medicaid Services administrative claims data, this study evaluated 1-year outcomes of mortality, stroke, and rehospitalization among 12,182 patients who underwent TAVR between November 2011 and June 2013.  In this cohort, the 1-year mortality rate 23.7%, the stroke rate was 4.1%, the rate of heart failure was 14.3%, and 1.4% had aortic valve reintervention.  A total of 53.2% were readmitted to the hospital within 1-year.    more…

Transcatheter aortic valve implantation – are we moving from equivalent to preferred in high-risk surgical patients?

23 Jul, 14 | by Alistair Lindsay

Transcatheter aortic valve implantation (TAVI) has expanded the options for the treatment of severe aortic stenosis, particularly in patients for whom the surgical risk of valve replacement is felt to be prohibitive.  Prior studies have demonstrated TAVI reduces mortality relative to medical management among patients unable to undergo valve surgery.  Among patients considered to be at high surgical risk, TAVI has been shown to have similar 1-year survival compared to surgery, but associated with a higher rate of stroke.  In this study of the CoreValve self-expanding transcatheter bioprosthethic valve, patients deemed to be at high surgical risk (estimated risk of death ≥ 15% within 30 days of surgery) were randomized in a 1:1 fashion to either TAVI or surgical valve replacement.  more…

2-year PARTNER data published

25 Apr, 12 | by Alistair Lindsay

While the last 5 years have seen an incredible expansion in the use of transcatheter aortic-vlave replacement (TAVR) for patients with severe aortic stenosis who are not considered suitable for surgery, long-term outcomes data remain scant.  The randomised Placement of Aortic Transcatheter Valves (PARTNER) trial found that, as compared with standard therapy, TAVR reduced symptoms and decreased death at one year.  Two year follow-up data from the trial have now been published. more…

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