A large real-world study from Italy suggests surgical aortic valve replacement (SAVR) offers better long-term survival than transcatheter aortic valve replacement (TAVR) for patients aged 65 to 80 with severe aortic stenosis.
Key findings:
- Analysis included over 7,000 patients from Lombardy and Puglia.
- After 30 days, mortality was slightly lower for TAVR (1.3–2.2%) versus SAVR (1.9–3.1%).
- From one year onward, mortality rates diverged significantly, favoring SAVR:
- Lombardy: 24.6% (SAVR) vs. 47.2% (TAVR)
- Puglia: 18.1% (SAVR) vs. 44.1% (TAVR)
Researchers adjusted for age and comorbidities through propensity matching but noted SAVR’s recent surgical advances may explain its superior outcomes in real-world settings.
Cautionary note:
Authors advise against routinely preferring TAVR for patients under 80 unless surgery is contraindicated.
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