Transcatheter aortic valve replacement (TAVR) is a safe, effective option for treating asymptomatic patients, according to a new analysis published in the American Journal of Cardiology.
It is widely known that TAVR and surgical aortic valve replacement (SAVR) were comparable treatment options for symptomatic patients with severe aortic stenosis, the study’s authors explained, but the use of TAVR among asymptomatic patients “has not been established.”
The group hoped to gain a better understanding of this topic by tracking data from 138 asymptomatic patients who received care from March 2016 to November 2018. The group’s mean age was 74.2 years old, and 73% of them were men.
While 76 of the asymptomatic patients underwent TAVR, the remaining 62 patients underwent SAVR. Characteristics of the two groups were mostly similar, but chronic lung disease was more common among TAVR patients.
Overall, the composite rate of all-cause mortality or disabling stroke after 30 days was 1.3% among TAVR patients and 4.8% among SAVR patients. After 12 months, meanwhile, the rates were 1.3% among TAVR patients and 6.5% among SAVR patients.
In addition, while aortic valve hemodynamics improved for both groups, TAVR patients had “significantly lower” aortic valve mean gradients. The mean effective orifice area was also “significantly larger” among TAVR patients after 12 months than SAVR patients.
The team also focused on quality-of-life changes among both patient groups, noting that the TAVR cohort was associated with more consistent improvements.
“Despite being deemed asymptomatic, patients with TAVR had significant improvements in functional status within 30 days of the index procedure even with a significantly higher proportion of patients with chronic obstructive pulmonary disease,” wrote first author William M. Merhi, DO, of Spectrum Health Hospitals in Grand Rapids, Michigan, and colleagues. “The improved functional status was maintained at 12 months follow-up. Patients with SAVR also developed improved functional status but took longer to achieve, most likely related to the postoperative recovery period.”
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Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.