NOTION: TAVI with low risk at 4 year follow up

Courtesy of the SBHCI.

NOTION: TAVI with Low Risk at 4 Year Follow UpThere is little data about the use of transcatheter aortic valve replacement (TAVR) to treat patients with severe aortic stenosis at low surgical risk. Many of the questions involve long term duration of valves (over 10 years) when treating younger patients with longer life expectancy.

 

The NOTION study aims at comparing TAVR (with the self-expandable CoreValve) vs. conventional valve replacement surgery in patients over 70 years old at low surgical risk. This article reports on its 4 year outcomes.

 

The NOTION (Nordic Aortic Valve Intervention) randomized 280 patients between 2009 and 2013 with a mean STS of around 3 (more than 80% had <4 STS).

 

Primary end point was a composite of death, infarction or stroke according to VARC II criteria, that resulted 30.2% at 4 year follow up for patients undergoing surgery vs. 29.1% for the TAVR group (p=0.76).

 

Global mortality was 23% for surgery vs. 20% for the TAVR group (p=0.56). Also the rate of stroke resulted similar (surgery 7.3% vs. TAVR 6.8%), as well as that of infarction.

 

When looking only at patients between 70 and 75 (all with STS ≤4), primary end point was 27.2% for surgery and 15.6% for TAVR (p=0.24).

 

The differences between methods were seen in atrial fibrillation, that was far more frequent in the surgery group (60.2% vs 24.5%; p<0.001), and in the need for pacemaker, far more frequent with TAVR (9% vs. 43.7%, p<0,001).

 

Conclusion

Patients with severe aortic stenosis at low risk randomized to surgery vs. transcatheter aortic valve replacement showed similar results at 4 years as regards primary end point.

 

Differences were seen basically in new atrial fibrillation rate, which favored TAVR and in the need of pacemaker, which favored surgery. 

 

Courtesy of SBHCI

 

Dr. Lars Sondergaard
Dr. Lars Sondergaard.

Original Title: Clinical, safety and echocardiographic outcomes from NOTION trial: 4-year follow-up data in all-comer patients with severe aortic valve stenosis.

Presenter: Lars Sondergaard.

 

 

 


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...

TAVR in Young Low-Risk Patients

Transcatheter aortic valve replacement (TAVR) has established itself as an effective strategy for the treatment of severe aortic stenosis across different risk groups. While previous...

TAVR and Atrial Fibrillation: What Anticoagulants Should We Use?

The prevalence of atrial fibrillation (AF) in TAVR patients ranges from 15 to 30%, depending on series. This arrhythmia has been associated to higher...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...