A 78-year-old female with prior CVA and severe COPD has progressive dyspnea with NYHA class IV symptoms. An echocardiogram revealed severe aortic stenosis with aortic valve area of 0.6 cm2, peak gradient of 52 mmHg and normal left ventricular function. Surgical risk assessment revealed STS predicted risk mortality to be 16%.
Based on the randomized trial comparing TAVR vs SAVR, the following statement is most appropriate regarding this patient:
- TAVR has shown similar or lower mortality compared to SAVR at one year.
- SAVR has shown to be superior to TAVR at one year.
- SAVR has consistently shown higher CVA than TAVR at one year.
- TAVR has lower prosthetic regurgitation than SAVR.
Correct Answer: A
In the comparative trials of TAVR and SAVR in high risk AS patients, TAVR has shown to have similar or lower mortality compared to SAVR at 2 – 5 years of follow-up.
- Smith CR, Leon, MB, Mack MJ, et al., Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 2011;364:2187-98
- Adams, DH, Popma, JJ, Reardon, MJ, et al., Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med 2014;370:1790-8
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