More than 45% of patients in UK survive 5 years after TAVR

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Sapien transcatheter aortic valve.
Source: Edwards Lifesciences

Five years after patients underwent transcatheter aortic valve replacement (TAVR), 45.5 percent were still alive, according to an analysis of a United Kingdom registry.

Researchers found the three- and five-year mortality rates did not differ based on the type of device used, the access route or paravalvular leak.

Lead researcher Alison Duncan, PhD, of the Biomedical Research Unit at the Royal Brompton Hospital in London, and colleagues published their findings online in the Journal of the American College of Cardiology: Cardiovascular Interventions on April 27.

The study included 850 patients with severe symptomatic aortic stenosis who underwent TAVR at 25 centers in England and Wales between Jan. 1, 2007 and Dec. 31, 2009. The mean age was 82 years, and 52 percent of patients were male.

At baseline, 47.2 percent of patients had coronary artery disease, 29.8 percent had peripheral vascular disease, 23.9 percent had atrial fibrillation and 30.4 percent had previous cardiac surgery.

Of the TAVR procedures performed, 52.5 percent used the CoreValve (Medtronic) and 47.5 percent used the Sapien valve (Edwards Lifesciences).

At three years, 61.2 percent of patients were alive, and independent predictors of mortality were renal dysfunction, atrial fibrillation, logistic European System for Cardiac Operative Risk Evaluation, respiratory dysfunction and ventricular dysfunction. At five years, predictors of mortality were coronary artery disease and age. The only independent predictor of mortality at three and five years was periprocedural stroke.

The researchers said a limitation of the study was that they gathered the data from a registry. They wrote that the data on the number of procedures and survival outcomes were robust, although data on morbidity and complications were not as robust.