High-risk surgical patients with severe aortic stenosis who underwent a transcatheter aortic valve replacement experienced higher one-year survival rates than patients who underwent traditional surgical aortic valve replacement, according to a study in the New England Journal of Medicine.
Researchers examined the one-year survival rates of 747 patients considered to be at increased risk for surgery, 390 of whom underwent TAVR and 357 of whom underwent surgery. Patients were considered at increased risk if two cardiac surgeons and an interventional cardiologist estimated the risk of 30-day mortality or irreversible complications was between 15 and 50 percent.
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At the one-year mark, rate of death by any cause in the TAVR group was 14.2 percent, compared to 19.1 percent in the surgical group.
Additionally, the rate of major cardiovascular or cerebral adverse events at one year was lower in the TAVR group than the surgical group, at 20.4 percent and 27.3 percent, respectively.
However, the TAVR group experienced a higher rate of major vascular complications — such as conduction-system disturbances requiring permanent implantation of a pacemaker — than the surgical group, at 5.9 percent and 1.7 percent, respectively.
Researchers concluded the one-year mortality for TAVR procedure for patients at increased surgical risk was less than the mortality rate for patients who underwent traditional valve replacement surgery.
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