Surgical heart valve innovation has stalled, while transcatheter technologies rapidly evolve, according to cardiac surgeons Michael A. Borger, MD, PhD, and Mateo Marin-Cuartas in a recent Journal of the American College of Cardiology commentary.
The authors cite Foldax’s polymer Tria mitral valve—approved in India with positive one-year data—as a rare recent surgical innovation. They note that surgical valve technology is now mature, with strong outcomes expected, reducing urgency for new developments.
Conservatism within the cardiac surgery community and a focus on comparing existing procedures may also hamper research and investment. The surgeons highlighted numerous trials pitting transcatheter aortic valve replacement (TAVR) against surgical aortic valve replacement (SAVR), with TAVR favored by patients despite surgery’s durability, especially in younger individuals.
Borger and Marin-Cuartas call for improved data organization, new randomized trials, and increased research investment to highlight surgery’s long-term benefits.
“If transcatheter trials confirm surgical advantages in lower-risk patients, industry may reconsider its relationship with cardiac surgery,” they wrote. Renewed innovation would benefit patients and the specialty alike.
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