How pairing SAVR with additional heart surgeries affects mortality risk
How pairing SAVR with additional heart surgeries affects mortality risk
Published: July 21, 2025
Journal of the American College of Cardiology
Key Scientific Points:
1. Study Objective: Evaluate outcomes of patients undergoing surgical aortic valve replacement (SAVR) with or without concomitant procedures (e.g., CABG, mitral/tricuspid repair).
2. Methodology:
• Retrospective cohort using U.S. Medicare data (2017–2022).
• Included >100,000 SAVR patients (no prior cardiac surgery/infection/ACS).
• Median follow-up: 3.1 years; median age: 72–75 years.
3. Findings – 30-Day Mortality:
• Isolated SAVR: 2.3%
• SAVR + CABG: 3.6%
• SAVR + Mitral Valve: 7.5%
• SAVR + CABG + Mitral Valve: 11.7%
4. Findings – 5-Year Mortality:
• Isolated SAVR: 19.1%
• SAVR + CABG + Mitral Valve: 49.1%
• SAVR + Tricuspid Valve: notably lower at 18.1%
5. Key Insight:
• Adding procedures to SAVR increases both short- and long-term mortality in elderly patients.
• Tricuspid intervention was an exception, showing slightly lower 5-year mortality.
6. Comparison to PARTNER 3:
• Unlike PARTNER 3 (which showed no mortality difference), this study included older, high-risk patients and multivalve interventions.
