Is Rheumatic Etiology Counter Indicated for TAVR?

Patients with rheumatic aortic stenosis have been systematically excluded from all studies on transcatheter aortic valve replacement (TAVR). 

¿La etiología reumática es contraindicación para el TAVI?

This study compared TAVR vs surgical aortic valve replacement (SAVR) outcomes in patients with rheumatic aortic stenosis and also vs TAVR outcomes in patients with degenerative aortic stenosis

The study looked at rheumatic aortic stenosis patients receiving TAVR and SAVR between 2015 and 2017. 

After adjusting variables and confounders with propensity score, the final cohort included 1159 patients with rheumatic stenosis (554 SAVR and y 605 TAVR) and 88554 patients with degenerative stenosis undergoing TAVR. Study end point was all cause mortality, and secondary end points were multiple. 

Surgical patients were often younger, had lower surgical risk, fewer comorbidities and were stronger. 

After over 18 months, mortality resulted similar between patients with rheumatic stenosis undergoing SAVR vs. TAVR (11.2% vs 7%; p=0.2).


Read also: Watch again our Webinar on Lower Limb Angioplasty: LATAM Peripheral Registry.


Neither were there differences in mortality when comparing rheumatic stenosis vs. degenerative stenosis undergoing TAVR in the same period. 

Conclusion

Transcatheter aortic valve replacement is a viable and durable alternative to SAVR in patients with rheumatic aortic stenosis.  

Original Title: Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Rheumatic Aortic Stenosis.

Reference: Amgad Mentias et al. J Am Coll Cardiol. 2021 Apr 13;77(14):1703-1713. doi: 10.1016/j.jacc.2021.02.032.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

TCT 2024 | TRISCEND II: A New Hope in Percutaneous Tricuspid Valve Replacement

Advanced tricuspid regurgitation (TR) is a debilitating disease associated with heart failure and increased mortality.  Edge-to-edge repair has been shown to improve both clinical condition...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....