SCAI Reports Findings of Long-Term Analysis Comparing Outcomes of TAVR and SAVR

May 23, 2024—The Society for Cardiovascular Angiography & Interventions (SCAI) recently announced findings from a new study that demonstrated parity between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR).

In the meta-analysis of seven randomized trials, investigators compared the outcomes of 7,785 patients undergoing TAVR to those undergoing SAVR for severe aortic stenosis. The study found no significant difference in death or disabling stroke between TAVR and SAVR patients (hazard ratio, 1.02; 95% CI, 0.93-1.11; P = .7) with similar long-term mortality risks, reported SCAI.

The study findings, which were presented at EuroPCR 2024 held May 14-17 in Paris, France, were published by Giuseppe Talanas, MD, et al in JSCAI.

“This study represents the largest scale analysis so far available comparing longer-term percutaneous devices for aortic valve replacement versus surgery,” commented study investigator Eliano Pio Navarese, MD, in the SCAI press release. “Our findings support the comparable long-term safety and efficacy of TAVR, as well as raise important considerations for valve type selection, particularly when we are dealing with longer-term valve durability and pacemaker implantation.” Dr. Navarese is head of clinical experimental cardiology and associate professor at the University of Sassari in Sassari, Italy.

According to SCAI, the results were consistent across different surgical risk profiles (low, intermediate, and high). Compared with SAVR, TAVR was associated with an increased likelihood of needing a pacemaker and moderate-to-severe paravalvular leaks.

Notably, on a prespecified analysis, the study addressed the outcomes of two distinct TAVR devices versus SAVR. Compared with SAVR, self-expanding TAVR prostheses demonstrated lower death or stroke risk (P = .06), valve thrombosis (P = .06), and valve gradients (P < .01) but higher pacemaker implantation rates (P < .01) than balloon-expandable TAVR, highlighting potential long-term differences between the two percutaneous TAVR devices, stated SCAI.