PARTNER II Quality of Life: TAVR vs. SAVR in Intermediate-Risk Severe AS

Patients with severe aortic stenosis (AS) at intermediate surgical risk undergoing transcatheter aortic valve replacement (TAVR) had similar two-year quality of life outcomes compared to patients undergoing surgical valve replacement (SAVR), according to the results of the PARTNER II Quality of Life Trial presented Nov. 1 at TCT 2016.

David J. Cohen, MD, et al., assessed the quality of life of patients in the PARTNER II Trial – who were randomized to TAVR with the SAPIEN XT valve (n=1,011) or SAVR (n=1,021) – at baseline, one, 12 and 24 months using the Kansas City Cardiomyopathy Questionnaire (KCCQ), SF-36 and EQ-5D. Previous studies have shown the early quality of life benefit in patients with severe AS at high surgical risk who undergo TAVR.

The results of the study showed that at two-year follow-up, there were no significant differences between TAVR and SAVR in any quality of life measures. Both TAVR and SAVR were associated with clinically and statistically significant improvements in disease-specific and generic quality of life measures at two years as compared with baseline. The two-year change in KCCQ Overall Summary Score was 19.2 points with TAVR compared with 18.3 points for SAVR. Similarly, the two-year change in the SF-36 Physical Component Summary Score was 3.0 points with TAVR versus 2.7 points with SAVR.

In contrast, at one month, TAVR was associated with significantly better quality of life than SAVR, but this difference was restricted to patients who were treated via transfemoral access and was not seen in patients that were treated via transapical or transaortic access.

The authors of the study note that “these early differences in quality of life [in transfemoral TAVR versus SAVR] may be important to many patients who are suitable candidates for both procedures. Longer term follow-up is needed to assess the durability of quality of life improvement with TAVR versus SAVR in this intermediate risk population.”

Clinical Topics: Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Valvular Heart Disease, Aortic Surgery, Cardiac Surgery and Heart Failure, Cardiac Surgery and VHD, Interventions and Structural Heart Disease

Keywords: Transcatheter Cardiovascular Therapeutics, Aortic Valve, Aortic Valve Stenosis, Cardiac Surgical Procedures, Heart Valve Diseases, Health Status, Heart Valve Prosthesis, Quality of Life, Cardiomyopathies, Follow-Up Studies, Heart Valve Prosthesis Implantation, Surgical Instruments, Transcatheter Aortic Valve Replacement


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