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Propensity-Matched Comparison of Evolut-R Transcatheter Aortic Valve Implantation With Surgery in Intermediate-Risk Patients (from the SURTAVI Trial).
Journal article

Propensity-Matched Comparison of Evolut-R Transcatheter Aortic Valve Implantation With Surgery in Intermediate-Risk Patients (from the SURTAVI Trial).

  • Yakubov SJ Riverside Methodist - Ohio Health, Columbus, Ohio. Electronic address: steven.yakubov@ohiohealth.com.
  • Van Mieghem NM Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Reardon MJ Houston-Methodist-Debakey Heart and Vascular Center, Houston, Texas.
  • Serruys PW International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom.
  • Gada H University of Pittsburgh Medical Center Pinnacle Heath, Harrisburg, Pennsylvania.
  • Mumtaz M University of Pittsburgh Medical Center Pinnacle Heath, Harrisburg, Pennsylvania.
  • Deeb GM University of Michigan Hospitals, Ann Arbor, Michigan.
  • Kodali S Structural Heart and Valve Center, Columbia University Medical Center, New York, New York.
  • George I Structural Heart and Valve Center, Columbia University Medical Center, New York, New York.
  • Windecker S University Hospital Bern, Bern, Switzerland.
  • Kleiman N Houston-Methodist-Debakey Heart and Vascular Center, Houston, Texas.
  • Chetcuti SJ University of Michigan Hospitals, Ann Arbor, Michigan.
  • Sanchez C Riverside Methodist - Ohio Health, Columbus, Ohio.
  • Dauerman HL University of Vermont Medical Center, Burlington, Vermont.
  • Li S Medtronic, Minneapolis, Minnesota.
  • Popma JJ Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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  • 2020-07-30
Published in:
  • The American journal of cardiology. - 2020
Aged
Aged, 80 and over
Aortic Valve Stenosis
Female
Heart Valve Prosthesis
Humans
Male
Postoperative Complications
Propensity Score
Risk Assessment
Risk Factors
Transcatheter Aortic Valve Replacement
English The SURTAVI trial demonstrated the noninferiority of transcatheter aortic valve implantation (TAVI) to surgical aortic valve replacement (SAVR) in patients with severe, symptomatic aortic stenosis at intermediate surgical risk. Most TAVI patients received an early generation device which is no longer commercially available. This analysis compares TAVI outcomes in patients that received the Evolut R valve to those of similar patients randomized to SAVR in the SURTAVI trial. The continued access study of SURTAVI (CAS) enrolled 290 patients. Of them, 252 were implanted with the 23, 26, or 29 mm Evolut R device. Propensity-score matching between this group and SURTAVI SAVR patients with annular diameter of 26 mm or less was based on 22 clinical characteristics, resulting in 197 matched pairs for analysis. The primary end point for comparison was the rate of all-cause mortality or disabling stroke at 1-year. The mean age for TAVI and SAVR patients in the propensity-score matched population was 79.1 years and STS-PROM was 4.0 ± 1.5% for TAVI and 3.9% ± 1.3% for SAVR. The rate of all-cause mortality or disabling stroke at 30-days significantly favored TAVI (0.5% vs 5.1%; p = 0.006). At 1-year TAVI was numerically favored (4.1% vs 8.2%; p = 0.082). In conclusion, compared with SAVR, TAVI using Evolut R had a favorable 30-day safety profile, significantly better hemodynamic performance, and a comparable 1-year rate of all-cause mortality or disabling stroke, suggesting this may be a preferred treatment for patients with severe, symptomatic aortic stenosis at intermediate surgical risk.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/233772
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