2022
DOI: 10.1001/jama.2022.5776
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Effect of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement on All-Cause Mortality in Patients With Aortic Stenosis

Abstract: Key PointsQuestionIs transcatheter aortic valve implantation (TAVI) noninferior to surgical aortic valve replacement (surgery) in patients aged 70 years or older with severe, symptomatic aortic stenosis and moderately increased operative risk?FindingsIn this randomized clinical trial that included 913 patients at moderately increased operative risk due to age or comorbidity, all-cause mortality at 1 year was 4.6% with TAVI vs 6.6% with surgery, a difference that met the prespecified noninferiority margin of 5%… Show more

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Cited by 91 publications
(51 citation statements)
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“…The National Institute for Health and Care Excellence recommends SAVR as a first-line interventions and TAVR for patients who are at high surgical risk or if surgery is unsuitable ( 21 ). However, with the results of the UK TAVI trials, the authors predicted that the volume of TAVR will continue to increase and exceed SAVR in the United Kingdom ( 22 ). Indeed, in the NACSA 2022 reports, the ratio of TAVR to SAVR rose from 1.2:1 to 2.3:1, which dramatically accelerated during the COVID-19 pandemic ( 23 ).…”
Section: Discussionmentioning
confidence: 99%
“…The National Institute for Health and Care Excellence recommends SAVR as a first-line interventions and TAVR for patients who are at high surgical risk or if surgery is unsuitable ( 21 ). However, with the results of the UK TAVI trials, the authors predicted that the volume of TAVR will continue to increase and exceed SAVR in the United Kingdom ( 22 ). Indeed, in the NACSA 2022 reports, the ratio of TAVR to SAVR rose from 1.2:1 to 2.3:1, which dramatically accelerated during the COVID-19 pandemic ( 23 ).…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, in our institution, there was a further expansion of TAVR indications to encompass lower-risk patients, as outlined in the updated 2017 ESC/EACTS guidelines on the management of valvular heart disease ( 51 ). Finally, our practices are changing given the most recent evidence that among patients aged 70 years or older with severe, symptomatic aortic stenosis and moderately increased operative risk, TAVR was non-inferior to surgery with respect to all-cause mortality at 1 year ( 52 ).…”
Section: Discussionmentioning
confidence: 99%
“…Though TAVR was associated with more vascular complications, paravalvular leaks, and permanent pacemaker placement, it had fewer chances of acute bleeding problems and shortened the hospital stay. The risk of stroke was found to be similar between both groups [ 39 ].…”
Section: Reviewmentioning
confidence: 99%