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Five Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial

Thursday, January 23, 2025

Submitted by

Mateo Marin-Cuartas

Source

Source Name: The Annals of Thoracic Surgery

Source URL: https://www.annalsthoracicsurgery.org/article/S0003-4975(24)01090-7/abstract

Author(s)

Vinod H. Thourani, Martin B. Leon, Raj Makkar, Guido Ascione, Wilson Y. Szeto, Mahesh V. Madhavan, Susheel K. Kodali, Rebecca T. Hahn, Philippe Pibarot, S. Chris Malaisrie, Samir R. Kapadia, Mark J. Russo, Howard C. Herrmann, Vasilis Babaliaros, Robert Guyton, Philippe Genereux, David J. Cohen, Brandon Park, Sarah Clarke, Marissa Gunnarsson, Molly Szerlip, Julien Ternacle, Jonathon Leipsic, Philipp Blanke, John G. Webb, Craig R. Smith, Michael J. Mack

The authors evaluated the five-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial. In the PARTNER 3 trial, 454 patients with severe, symptomatic, tricuspid aortic stenosis (AS) underwent surgery and were followed for five years. Patients were stratified into those undergoing isolated SAVR (n=334, 73.6 percent) vs. concomitant SAVR (n=120, 26.4 percent). The mean age was 73.6 plus or minus 6.1 years, and 71.1 percent were male. The median SAVR implant size was 23 mm overall. Five-year all-cause mortality was 9.0 percent for all patients (8.5 percent for isolated SAVR versus 10.2 percent for concomitant SAVR, p=0.58). The average five-year mean gradient was 11.7 plus or minus 5.6 mmHg overall. Reintervention rates were low in both groups (2.3 percent for isolated SAVR vs. 5.0 percent for concomitant SAVR, p=0.21), and the majority of patients (87.9 percent for isolated SAVR vs. 86.1 percent for concomitant SAVR) were alive with no evidence of bioprosthetic valve failure at five years. The authors concluded that SAVR in low-risk patients in the PARTNER 3 trial demonstrated excellent five-year outcomes. Five-year mortality was similar in patients undergoing isolated vs. concomitant SAVR. This was comparable to recently published national SAVR outcomes, supporting the generalizability of these findings.