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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Outcomes in 937 Intermediate-Risk Patients Undergoing Surgical Aortic Valve Replacement in PARTNER-2A
Vinod H Thourani1, Jessica Forcillo2, Wilson Y Szeto3
1MedStar Heart and Vascular Institute, Washington, DC; Georgetown University, Washington, DC.
The Annals of Thoracic Surgery
|December 19, 2017
Summary
Surgical aortic valve replacement (SAVR) in intermediate-risk patients showed excellent 2-year outcomes, despite higher-than-expected stroke rates. Long-term surveillance is crucial for assessing severe aortic stenosis treatment effectiveness.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- The PARTNER-2A trial compared transcatheter aortic valve replacement with surgical aortic valve replacement (SAVR) in intermediate-risk patients.
- This study focuses on analyzing SAVR outcomes within the PARTNER-2A trial population.
Purpose of the Study:
- To conduct an in-depth analysis of outcomes following SAVR in intermediate-risk patients with severe aortic stenosis.
- To evaluate the safety and efficacy of SAVR in this specific patient cohort.
Main Methods:
- Analysis of data from 937 patients who underwent SAVR between January 2012 and January 2014.
- Independent adjudication of major outcomes and echocardiograms with 2-year follow-up completion in 94% of patients.
Main Results:
- Operative mortality was 4.1%, lower than the predicted risk (5.2%).
- In-hospital stroke rate was 5.4%, double the expected rate.
- Severe prosthesis-patient mismatch did not impact survival; less-invasive SAVR also showed similar outcomes.
Conclusions:
- SAVR demonstrated excellent 2-year results in intermediate-risk patients.
- Increased in-hospital strokes may be linked to post-procedure neurologic assessments.
- No significant structural valve deterioration was observed within 2 years, emphasizing the need for continued surveillance.
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