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Selection for Transcatheter Versus Surgical Aortic Valve Replacement and Mid-Term Survival: Results of the AUTHEARTVISIT Study

Thursday, October 24, 2024

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Source

Source Name: European Journal of Cardio-Thoracic Surgery

Author(s)

Johann Auer, Pavla Krotka, Berthold Reichardt, Denise Traxler, Ralph Wendt, Michael Mildner, Hendrik Jan Ankersmit, Alexandra Graf

There is limited data available from randomized trials comparing outcomes between transcatheter aortic valve replacement (TAVR) and surgery in patients with different risks and follow-up periods of at least four years or longer. In this population-based cohort study, long-term mortality and morbidity were investigated in 18,882 patients in Austria undergoing surgical aortic valve replacement (SAVR) for severe aortic stenosis using a surgically implanted bioprosthesis. The primary outcome assessed was all-cause mortality in the overall and propensity score-matched populations, with secondary outcomes of reoperation and cardiovascular events. The study found that selection for TAVR was significantly associated with higher all-cause mortality compared to SAVR in patients 65 years and older with severe, symptomatic aortic stenosis over a follow-up period exceeding two years. 

Comments

I believe the difference in mortality and the need for redo aortic valve replacement will become more significant in favour of SAVR with longer follow up period
Also with longer follow up we will see more patients will need redo surgery and the mortality risk of such patients most likely will be higher in those who had TAVR as first operation

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