Transcatheter aortic valve implantation (TAVI) was superior to surgical aortic valve replacement (SAVR) in women with severe aortic stenosis (AS), according to results from the RHEIA trial published April 2 in the European Heart Journal.

A total of 443 women (mean age, 73 years) across 48 European centers were randomized 1:1 to receive transfemoral TAVI with a third-generation balloon-expandable valve (n=215) or SAVR (n=205). The composite primary endpoint was all-cause mortality, stroke or rehospitalization for valve or procedure-related symptoms or worsening heart failure at one year.

Results showed significantly lower Kaplan-Meier estimates of primary endpoint event rates at one year in the TAVI group (8.9%), compared with the SAVR group (15.6%). Broken down by individual events, rates of all-cause death were 0.9% for TAVI vs. 2.0% for surgery, stroke were 3.3% vs. 3.0%, and rehospitalization were 5.8% vs. 11.4%. Researchers noted that among the rehospitalizations, two were considered valve-related and eight were procedure-related in the TAVI group, while four rehospitalizations were considered valve-related and 19 were procedure-related in the SAVR group.

"In women with severe AS, TAVI may be the preferred treatment option compared to surgery," said Didier Tchetche, MD, et. al. "However, more follow-up is needed to assess long-term clinical outcomes and valve durability following TAVI vs. surgery in women."