Traditionally, patients with a failing heart valve were advised to return in six to 12 months, as physicians generally took a "wait and see" approach, but a new study suggests patients may benefit more if their valves are replaced immediately through a minimally invasive procedure.
The study, published Oct. 28 in The New England Journal of Medicine, enrolled 901 patients with asymptomatic severe aortic stenosis from 75 centers in the U.S. and Canada. About half of the patients underwent early transcatheter aortic valve replacement (TAVR), while the other half were placed under clinical surveillance.
Here are four findings:
- Death occurred in 8.4% of patients who had TAVR, compared to 9.2% of those under clinical surveillance.
- Other adverse events were more common in the clinical surveillance group. Strokes occurred in 4.2% of TAVR patients compared to 6.7% for surveillance. Unplanned hospitalizations for cardiovascular causes occurred in 20.9% of TAVR patients versus 41.7% in the surveillance group.
- After a 3.8-year follow-up period, 87% of patients in the surveillance group had undergone aortic-valve replacement.
- The study found no difference in procedure-related adverse events between the groups.
"Among patients with asymptomatic severe aortic stenosis, a strategy of early TAVR was superior to clinical surveillance in reducing the incidence of death, stroke or unplanned hospitalization for cardiovascular causes," the study authors wrote.