Tavr versus surgery in low-risk patients

Access through your institution Buy or subscribe Transcatheter aortic valve replacement (TAVR) was initially developed >1 decade ago for elderly patients with severe aortic stenosis who

were at very high or prohibitive surgical risk, but international guidelines have since expanded its use to include patients at intermediate risk, given trial data showing that TAVR was

noninferior to surgical aortic valve replacement in this patient group. Now, two new clinical trials report that TAVR with a balloon-expandable valve or a self-expanding valve is at least as

safe and effective as surgical aortic valve replacement in patients at low surgical risk. “The next step towards studying truly low-risk patients was a small one given the fact that so far,

no long-term penalties have been seen,” comments Nicolas M. Van Mieghem from Erasmus University Rotterdam, Netherlands, who was not part of the trials. “[In addition], the TAVR technique

has evolved even further towards a therapy [that is performed] under local anaesthesia, with a short stay at the intensive care unit and early discharge opportunities.” Results from the two

trials were presented at the ACC.19 Scientific Sessions in New Orleans, and simultaneously published in the _NEJM_. “Definitive conclusions regarding the advantages and disadvantages of TAVR

as compared with surgery await long-term clinical and echocardiographic follow-up,” state the researchers. All patients in the trial will be followed up for 10 years. This is a preview of

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* Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES ORIGINAL ARTICLES * Popma, J. J. et al. Transcatheter aortic-valve replacement with a

self-expanding valve in low-risk patients. _N. Engl. J. Med._ https://doi.org/10.1056/NEJMoa1816885 (2019) Article  PubMed  Google Scholar  * Mack, M. J. et al. Transcatheter aortic valve

replacement with a balloon-expandable valve in low-risk patients. _N. Engl. J. Med._ https://doi.org/10.1056/NEJMoa1814052 (2019) Article  PubMed  Google Scholar  FURTHER READING * Puri, R.

et al. Future of transcatheter aortic valve implantation — evolving clinical indications. _Nat. Rev. Cardiol._ 15, 57–65 (2018) Article  PubMed  Google Scholar  Download references AUTHOR

INFORMATION AUTHORS AND AFFILIATIONS * Nature Reviews Cardiology http://www.nature.com/nrcardio/ Karina Huynh Authors * Karina Huynh View author publications You can also search for this

author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Karina Huynh. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Huynh, K. TAVR versus

surgery in low-risk patients. _Nat Rev Cardiol_ 16, 319 (2019). https://doi.org/10.1038/s41569-019-0197-y Download citation * Published: 03 April 2019 * Issue Date: June 2019 * DOI:

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