Transcatheter Versus Surgical Aortic Valve Replacement in Patients Younger Than 65 Years in the US

Thursday, January 23, 2025

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Source

Source Name: The Journal of Thoracic and Cardiovascular Surgery

Source URL: https://www.jtcvs.org/article/S0022-5223(25)00002-9/abstract

Author(s)

Alabbadi, Michael E. Bowdish, Aminah Sallam, Derrick Y. Tam, Irsa Hassan, Abirami Kumaresan, Anas H. Alzahrani, Alexander Iribarne, Natalia Egorova, Joanna Chikwe

This retrospective analysis examined trends and outcomes of aortic valve replacement in patients under the age of 65 with aortic stenosis from 2013 to 2021, focusing on transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR). Among 9,557 patients, TAVR usage increased from 7.1 percent to 54.7 percent during the study period. While 30-day mortality was similar between the two groups, TAVR was associated with higher six-year mortality (23.3 percent versus 10.5 percent) and a greater need for permanent pacemaker implantation. These findings suggest the need for a randomized controlled trial to compare long-term outcomes between TAVR and SAVR in younger patients.

Comments

Submitted by Vinayak (Vinnie) Bapat on Sat, 2025-01-25 15:45

TAVR is performed ONLY when there is surgical approval for the procedure. So can the surgeons from California explain the rest of the CV surgery community why they agreed to TAvR in heart team discussion rather than crying foul later? Also, there is no robust data on durability of Bioprosthetic surgical valves in patients patients below 65 and after spectacular debacle of Trifecta we need to challenge ourselves and industry for better data and trials