Patients suffering from dysfunctional aortic heart valves have found new hope in minimally invasive treatment.
Research reveals that patients who received a prosthetic had outcomes similar to those who underwent open-heart surgery after five years.
The study focused on transcatheter aortic valve replacement (TAVR), which is gaining momentum as a promising alternative to traditional open-heart surgery.
The results support the routine use of TAVR, even in patients considered low-risk for surgical complications.
Dr Raj Makkar, the study’s senior author, said: ‘Our five-year data validate that TAVR is a good alternative to open-heart surgery in younger patients with aortic stenosis. They support routinely offering TAVR, even to patients for whom open-heart surgery wouldn’t pose a high risk.’
Aortic stenosis has long been treated with open-heart surgery. TAVR was FDA-approved in 2011 for high-risk patients with severe aortic stenosis, but it’s increasingly offered to a broader patient population.
Dr Eduardo Marbán, executive director of the Smidt Heart Institute, emphasised a patient-centred approach.
‘These findings support the approach of the Smidt Heart Institute: We individualise therapy to best address the patient’s needs. The choice of TAVR versus surgery should be tailored to each patient based on anatomy, which may affect the first procedure's success and the feasibility of a repeat TAVR procedure several years later when the first valve has degenerated.’
The clinical trial, PARTNER 3, involved recruiting patients from various health institutions worldwide and randomly assigning 1,000 low-risk patients with severe aortic stenosis to TAVR or surgery.
After a meticulous five-year follow-up, the study showed that the rates of death, stroke and rehospitalisation were similar between the two groups.
This research offers newfound hope to patients suffering from aortic stenosis and sets the stage for a more personalised approach to heart valve treatment.
The international multicentre study will continue to follow patients for 10 years to assess the durability of the prosthetic valves.
The study has key contributions by the Cedars-Sinai heart team and is published in The New England Journal of Medicine.
