TAVR Linked to Stronger Valve Performance Than SAVR in New 5-Year Study

JACC. March 9, 2025

TAVR Linked to Stronger Valve Performance Than SAVR in New 5-Year Study

Key Points: TAVR vs. SAVR in 5-Year Valve Performance Study

• Study Overview: New data from over 5,600 patients show that TAVR results in lower bioprosthetic valve dysfunction (BVD) rates than SAVR at five years.

• Data Sources: Included both RCT patients (41%) and non-RCT patients from CoreValve trials.

• Patient Demographics: Mean age 82.2 years, 45.2% women; all TAVR patients received Medtronic CoreValve/Evolut valves.

• BVD Rates:

• TAVR: 9.7% in RCT patients.

• SAVR: 15.3% in RCT patients.

• BVD Definition: Included structural and non-structural deterioration, thrombosis with clinical impact, and infectious endocarditis.

• Clinical Impact: BVD is associated with a higher risk of all-cause mortality, cardiovascular mortality, and hospitalization for valve disease/heart failure over five years.

• Key Conclusion: This is the first study to validate clinical BVD criteria and confirm a ≥50% increased five-year risk of death or hospitalization in affected patients.

• Future Outlook: A 10-year follow-up is ongoing. Findings highlight TAVR’s superior valve durability as a key factor in valve selection for patients with severe AS.

• Funding: Study sponsored by Medtronic, which also funded the SMART trial on long-term BVD risks.

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Also of Interest:

Early TAVR or SAVR for Asymptomatic Severe AS Limits Strokes, Hospitalizations

Published: March 7, 2025

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