17 Dec Mortality Decreasing From Both Aortic Valve Replacement and TAVR Procedures
MedicalResearch.com Interview with:
Dr. Jochen Reinöhl
Consultant and Head of the ISAH team (intervention for structural and congenital cardiovascular diseases)
Department of Cardiology and Angiology I (Medical Director: Prof. Dr. Christoph Bode)
University Heart Center Freiburg ∙ Bad Krozingen
Medical Research: What is the background for this study? What are the main findings?
Dr. Reinöhl: Aortic valve stenosis is a medical condition with very high short-term mortality. Previously its only treatment – therefore the gold standard – consisted of surgical valve replacement. Since 2007 transcatheter aortic-valve replacement (TAVR) can be considered alternative. Its impact on clinical practice, however, is largely unknown.
TAVR numbers rose from 144 in 2007 to 9,147 in 2013, whereas surgical aortic-valve replacement procedures only marginally decreased from 8,622 to 7,048. For both groups in-hospital mortality, as well as, the incidence of stroke, bleeding and pacemaker implantation (but not acute kidney injury) decreased.
Medical Research: What should clinicians and patients take away from your report?
Dr. Reinöhl: Since the introduction of TAVR in-hospital mortality decreased for both groups. This might potentially be in part attributed to crowding out of high-risk patients in the surgical group and in TAVR, due to technical advances and learning curve effects. Today, choosing the right treatment strategy for the right patient significantly reduces complications and improves clinical outcome.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Reinöhl: We are only at the beginning. TAVR technology will evolve further and will become the standard procedure in a few years.
Effect of Availability of Transcatheter Aortic-Valve Replacement on Clinical Practice
Jochen Reinöhl, M.D., Klaus Kaier, Ph.D., Holger Reinecke, M.D., Claudia Schmoor, Ph.D., Lutz Frankenstein, M.D., Werner Vach, Ph.D., Alain Cribier, M.D., Friedhelm Beyersdorf, M.D., Christoph Bode, M.D., and Manfred Zehender, M.D., Ph.D.
N Engl J Med 2015; 373:2438-2447
December 17, 2015 DOI: 10.1056/NEJMoa1500893
Dr. Jochen Reinöhl (2015). Mortality Decreasing From Both Aortic Valve Replacement and TAVR Procedure MedicalResearch.com