Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Surgery
  • Surgery News
  • Almost 50% of patients...

Almost 50% of patients under 60 years choose TAVR over SAVR with worse outcomes

Written By : Dr. Prem Aggarwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-01-30T01:45:31+05:30  |  Updated On 5 Feb 2024 4:31 PM IST
TAVR
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

Despite national guidelines recommending surgical aortic valve replacement (SAVR) for patients under age 65 with severe aortic stenosis, many hospitals are still opting for a nonsurgical approach in patients under 60-possibly with poorer survival rates.

In a study presented at The Society of Thoracic Surgeons’ 2024 Annual Meeting in San Antonio, Texas, researchers from the department of cardiac surgery in the Smidt Heart Institute at Cedars-Sinai in Los Angeles and the department of population health science and policy at Mount Sinai New York compared outcomes for patients undergoing surgery and those undergoing nonsurgical or transcatheter aortic valve replacement (TAVR) from 2013 to 2021 in California.

From a pool of 37,011 patients, the study identified 2,360 patients under the age of 60 years who underwent these procedures, with 22% receiving TAVR and 78% SAVR. By 2021 almost half of patients younger than 60 years were receiving TAVR rather than SAVR. The research team followed these patients for a median time of 2.4 years after TAVR and 4.9 years after SAVR to assess their outcomes.

The primary focus was on 5-year survival rates. Secondary outcomes included rates of reoperation, infective endocarditis, stroke, and hospital admissions for heart failure. Propensity score matching ensured a fair comparison of 358 pairs of patients, balancing factors such as age, major health conditions, hospital volume, and urgency.

While the 30-day mortality rates were similar (0.2% for SAVR vs. 0.4% for TAVR), the 5-year survival rate was significantly better after surgery compared to TAVR (98% vs. 86%, p < 0.001). For secondary outcomes, there was no significant difference between the two groups.

“While we expected that the volume of transcatheter therapy would increase over the study period in this young patient cohort, we were surprised there appears to be near equipoise in terms of procedure selection, with patients and clinicians opting for procedures against the 2020 guidelines,” said study coauthor Jad Malas, MD, a cardiothoracic surgery resident at Cedars-Sinai Medical Center in Los Angeles.

In their 2020 consensus guidelines, the American College of Cardiology and the American Hospital Association recommended surgery over TAVR in patients under 65 with severe aortic stenosis, a condition that stiffens and narrows the aortic valve, making blood flow more difficult. Dr. Malas and colleagues wanted a real-world snapshot of how hospitals are treating patients in an even younger cohort.

The study results indicate a need for randomized trials in younger patients (who represent fewer than 10% of the patients in randomized trials comparing these treatments)-as well as more balanced and informed patient-centered decision-making-to support more appropriate practice in this younger patient population, said Dr. Joanna Chikwe, senior author of the study and chair of the department of cardiac surgery in the Smidt Heart Institute at Cedars-Sinai. She added that her research group has expanded their analysis to include a multi-state registry for better comparison of the two procedures.

“As cardiac surgeons, we owe it to our patients to take a more prominent role in providing the highest quality evidence to help our patients make these major healthcare decisions,” she emphasized. “While transcatheter therapy appears more attractive to most patients, there are clearly long-term benefits with surgical therapy for the lifetime management of valvular heart disease in many patients.”

TAVRheart failuretranscatheter aortic valve replacementsurgical aortic valve replacement
Dr. Prem Aggarwal
Dr. Prem Aggarwal

Dr Prem Aggarwal, (MD Medicine, DNB Cardiology) is a Cardiologist by profession and also the Co-founder and Chairman of Medical. He focuses on news and perspectives about cardiology, and medicine related developments at Medical Dialogues. He can be reached out at drprem@medicaldialogues.in

Dr. Kamal Kant Kohli
Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

Show Full Article
Next Story

Editorial

Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

Relevance of Pioglitazone in Indian T2DM Care Continuum

Relevance of Pioglitazone in Indian T2DM Care Continuum

Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

First Indian Consensus on Managing Refractory Gastroesophageal Reflux Disease Recommends Vonoprazan

First Indian Consensus on Managing Refractory Gastroesophageal Reflux Disease Recommends Vonoprazan

View All

Journal Club Today

Study Reveals Why Your Immune System Works Better in Daylight

Study Reveals Why Your Immune System Works Better in Daylight

View All

Health News Today

Health Bulletin 30/May/2025

Health Bulletin 30/May/2025

View All
© 2022 All Rights Reserved.
Powered By: Hocalwire
X
We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok