Encouraging 3-year data for TAVR in low-risk patients from the Evolut trial. ACC23 WCCardio MedTwitter
Forrest also reported that TAVR patients continued to have better valve hemodynamics at 3 years and very low rates of valve thrombosis; moreover, rates of moderate or greater paravalvular regurgitation and paravalvular leak were also low, although mild paravalvular regurgitation was higher with TAVR.
"Uncertainty remains regarding long-term durability of the transcatheter valve in low-risk patients who are generally younger and likely more active than higher-risk cohorts," he added."The current 3-year results provide more confidence as the outcome curves for death and disabling stroke are trending in the right direction for TAVR vs surgery."
In the JACC paper, the authors report that the absolute difference between treatment arms for all-cause mortality or disabling stroke remained broadly consistent over time: -1.8% at year 1; -2.0% at year 2; and -2.9% at year 3. Forrest responded:"It was a fairly equal contribution — a little bit more cardiac death. We have to remember that although the average age in this study was 74, there were some patients over 80 who were still low-surgical-risk included so we are going to see noncardiac death as well."Hermiller drew attention to the high pacemaker rate in the TAVR group and asked how these patients fared in comparison to those who didn't need a pacemaker.
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