A two-year study of patients in the landmark PARTNER trial, which compared transcatheter aortic valve replacement (TAVR) in patients who have severe aortic stenosis and are not candidates for open heart surgery, confirm the one-year findings and support the role of TAVR as the standard of care.
Cohort B of the PARTNER trial ? those patients with severe aortic stenosis who were not candidates for surgery – randomized 358 patients to transfemoral TAVR with an early generation balloon-expandable bovine pericardial valve or standard therapy (ST, including balloon valvuloplasty) at 21 centers, emphasizing a multi-disciplinary heart team approach.
After two years, the rate of all cause mortality was 18.2% in the TAVR group and 35.1% in the standard therapy group. The rate of cardiovascular mortality was 13.2% in the TAVR group and 32.1% in the standard therapy group.
The rate of repeat hospitalization was 35.0% in the TAVR group and 72.5% in the standard therapy group.
The rate of stroke at two years was higher ? 13.8% in the TAVR group and 5.5% in the standard therapy group.
At two years, in patients with symptomatic severe aortic stenosis who are not suitable candidates for surgery, TAVR remained superior to standard therapy.
Transcatheter aortic valve implantation (TAVR) performed via the femoral artery is also associated with higher procedural costs but slightly lower index hospitalization and total 12 month costs.
Results of this trial indicate that for patients with severe aortic stenosis and high surgical risk, transcatheter aortic valve replacement is an economically attractive and possibly dominant strategy compared with surgical aortic valve replacement, provided that patients are suitable for the transfemoral approach, said Matthew R. Reynolds, MD. Dr. Reynolds is Director of the Economics and Quality of Life Research Center at Harvard Clinical Research Institute.
Results of the PARTNER Cohort A QOL study demonstrate that transcatheter aortic valve replacement (TAVR) results in improved quality of life compared with surgical valve replacement, but only when performed via the transfemoral approach.
Trial results were presented today at the 23rd annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation.
Source: Cardiovascular Research Foundation, USA