Excellent durability for SAVR and TAVR

Results from the PARTNER trial, published online on 27 September 2017, show that both surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) have excellent durability.

The PARTNER trial (Placement of AoRtic TraNscathetER Valves) is the world’s first prospective randomised controlled trial for TAVR. The trial assessed the safety and effectiveness of TAVR in patients with severe aortic stenosis.

Pamela Douglas from Duke University Medical Centre, Durham, US, and colleagues randomised patients to SAVR (313 patients) or TAVR (321 patients); TAVR (165 patients) or medical treatment; and those from continued access observational studies (TAVR, 1,996 patients).

Less than 4% of patients who had TAVR had moderate or severe transvalvular regurgitation. Stroke volume index, aortic valve mean gradient and lower ejection fraction were associated with death or reintervention after TAVR. Less than 1% of patients in both the TAVR and SAVR groups needed reintervention. Severely abnormal haemodynamics were rare and were not associated with excess death or reintervention for either approach.