DinoSAVR struck by the TAVR asteroids

• Main Authors: Giuseppe Tarantini, Luca Nai Fovino
• Format: Article
• Language: English
• Published: Permanyer 2019-05-01
• Series: REC: Interventional Cardiology (English Ed.)
• Subjects: Transcatheter aortic valve replacement; Low surgical risk; Randomized trial
• Online Access: https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=126

ABSTRACT Over the last decade, transcatheter aortic valve replacement (TAVR) has become the preferred treatment for patients with severe aortic stenosis at increased risk for surgery. Consequently, this new technology has been recently tested in low-risk subjects. The PARTNER 3 trial randomized 1000 patients (mean Society of Thoracic Surgeons score, 1.9%; mean age, 73 years) to undergo TAVR with a balloon-expandable valve or surgical aortic valve replacement showing that TAVR was superior in terms of the composite endpoint of death, stroke and re-hospitalization at 1 year. In the Evolut Low Risk trial that randomized 1468 patients with the use of a self-expandable prosthesis, TAVR was non-inferior to surgery for the primary composite endpoint of death or disabling stroke at 24 months. While the available 1-year follow up does not answer the question of transcatheter valves durability, these results will definitely change our everyday clinical practice.