New research reveals that surgical aortic valve replacement (SAVR) combined with other cardiac procedures significantly increases short- and long-term mortality among older patients.
Analyzing over 100,000 Medicare patients from 2017 to 2022, researchers found that 50% underwent SAVR alongside another procedure—most commonly coronary artery bypass grafting (CABG), thoracic aorta replacement, or mitral/tricuspid valve interventions.
Key findings include:
- 30-day mortality: 2.3% for isolated SAVR, rising to 11.7% for SAVR with CABG and mitral valve intervention.
- Five-year mortality: 19.1% for isolated SAVR versus 49.1% for SAVR plus CABG and mitral valve repair.
- An exception was SAVR with tricuspid intervention, which showed slightly better five-year survival (18.1%) than isolated SAVR.
This real-world data contrasts with the PARTNER 3 trial’s findings in low-risk patients, underscoring higher risks in older, more complex cases.
The authors stress the need for more focused research and registries to optimize treatment for elderly patients requiring multivalve and coronary interventions, especially as transcatheter therapies evolve.
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