Analysis From SURTAVI Compares Neurologic Complications in TAVR and SAVR

October 22, 2018—Findings from an analysis of neurologic events in the randomized SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation) trial were published by Andras P. Durko, MD, et al in Journal of the American College of Cardiology (JACC;2018:2109–2119).

Comparing neurologic complications after transcatheter aortic valve replacement (TAVR) and after surgical aortic valve replacement (SAVR) in intermediate-risk patients, the investigators found that the early stroke rate was lower after TAVR than after SAVR. In patients with early strokes, quality of life (QOL) improved earlier after TAVR. At 12-month follow-up, stroke rates and QOL were not different between TAVR and SAVR patients.

As summarized in JACC, patients with severe, symptomatic aortic stenosis at intermediate surgical risk were randomized 1:1 to TAVR or SAVR. The rates of neurologic events and QOL were analyzed at 30 days, and 6 and 12 months postprocedure in a modified intention-to-treat population (mean age, 79.8 ± 6.2 years; N = 1,660).

At 30 days, SAVR versus TAVR resulted in higher rates of stroke (5.4% vs 3.3%; P = .031) and postprocedural encephalopathy (7.8% vs 1.6%; P < .001).

At 12 months, the rate of stroke was not different between SAVR and TAVR (6.9% vs 5.2%; P = .136).

Early stroke and early encephalopathy resulted in an elevated mortality at 12 months in both treatment groups. QOL after an early stroke was significantly lower in SAVR versus TAVR patients at 30 days and was similar at 6 and 12 months, reported the investigators in JACC.