Why is the study important? 

This study adds to the growing literature about TAVR safety and durability in the intermediate to long-term. 

Should I change my practice because of these findings? 

This study provides promising results giving operators confidence about long-term durability with self-expanding TAVR valves. 

What question was the study supposed to answer? 

What is the 5-year safety and efficacy of the CoreValve/Evolut (Medtronic) self-expanding TAVR valve in severe AS. 

What did the study show? 

Data from the SURTAVI Trial at 5-years presented at TCT showed promising results for self-expanding valves versus SAVR.  The SURTAVI trial randomized 1,746 patients with severe symptomatic aortic stenosis to receive either a self-expanding (CoreValve/Evolut, Medtronic) TAVR versus surgical AVR (SAVR).  At 5-years, the primary endpoint of all-cause mortality or stroke was similar for TAVR vs. SAVR (31.3% vs. 30.8%, p=0.85).  Valve thrombosis was also similar (0.5% vs. 0.4%, p=0.51) and mean gradient (8.6 vs. 11.2 mmHg, p<0.001) and effective orifice area (2.2 vs. 1.8 cm2, p<0.001) were superior for TAVR.  Moderate to severe paravalvular leak was more common in the TAVR group (3.0% vs. 0.7%, p<0.001).  Of note, the majority of patients in SURTAVI received the first generation CoreValve® whereas only 16% received the Evolut R® valve. 

How good was the approach/methodology? 

Data presented at TCT and full text manuscript not yet available for review. 

All editors: Jared M. O'Leary, MD

Other Specialist Resources for Structural Heart Disease

Including recently published studies, coverage of late-breaking science, updates from clinical trials and registries, and complex case presentations. 

Clinical Interest Article

ADAPT-TAVR Trial—Coverage of ACC.22

Routine Use of Edoxaban Post-TAVR in Patients Without an Indication for Anticoagulation Does Not Significantly Reduce Valve Thrombo...