Transcatheter or Surgical Aortic Valve Replacement in Women With Small Annuli at Low or Intermediate Surgical Risk

•We pooled data from 2 randomized controlled trials, including 620 women with small annuli.•Women underwent self-expanding, supra-annular transcatheter aortic valve replacement (TAVR) or surgery.•All-cause mortality or disabling stroke was similar with TAVR versus surgery.•Hemodynamic outcomes were...

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Bibliographic Details
Published in:The American journal of cardiology 2024-07, Vol.223, p.147-155
Main Authors: Modine, Thomas, Forrest, John K., Van Mieghem, Nicolas M., Deeb, G. Michael, Yakubov, Steven J., Ali, Walid Ben, Tchétché, Didier, Lam, Ka Yan, Oh, Jae K., Huang, Jian, Mehran, Roxana, Reardon, Michael J.
Format: Article
Language:English
Subjects:
Annuli
Aorta
Aortic stenosis
Aortic valve
aortic valve replacement
Clinical outcomes
Clinical trials
Computed tomography
Endocarditis
Heart valves
Hemodynamics
Mortality
Orifices
Pacemakers
Patients
prosthesis-patient mismatch
Risk
small aortic annuli
Stroke
Surgery
Thrombosis
Ultrasonic imaging
women
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Summary:•We pooled data from 2 randomized controlled trials, including 620 women with small annuli.•Women underwent self-expanding, supra-annular transcatheter aortic valve replacement (TAVR) or surgery.•All-cause mortality or disabling stroke was similar with TAVR versus surgery.•Hemodynamic outcomes were significantly better with TAVR than surgery. There are limited data from randomized controlled trials assessing the impact of transcatheter aortic valve replacement (TAVR) or surgery in women with aortic stenosis and small aortic annuli. We evaluated 2-year clinical and hemodynamic outcomes after aortic valve replacement to understand acute valve performance and early and midterm clinical outcomes. This post hoc analysis pooled women enrolled in the randomized, prospective, multicenter Evolut Low Risk and Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) intermediate risk trials. Women with severe aortic stenosis at low or intermediate surgical risk who had a computed tomography–measured annular perimeter of ≤72.3 mm were included and underwent self-expanding, supra-annular TAVR or surgery. The primary end point was 2-year all-cause mortality or disabling stroke rate. The study included 620 women (323 TAVR, 297 surgery) with a mean age of 78 years. At 2 years, the all-cause mortality or disabling stroke was 6.5% for TAVR and 8.0% for surgery, p = 0.47. Pacemaker rates were 20.0% for TAVR and 8.3% for surgery, p
ISSN:0002-9149
1879-1913
1879-1913
DOI:10.1016/j.amjcard.2024.04.013