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
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