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Minimally Invasive Heart Valve Replacement Could Lead To Drop In Cardiac Surgery

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The procedure called transcatheter aortic valve replacement might be just as effective, and sometimes more beneficial than open-heart surgery among patients who have damaged aortic valves.

A multicenter clinical trial found that the minimally invasive procedure resulted in a significantly lower rate of stroke, rehospitalization, and death among patients who have the disease compared to those who underwent open-heart surgery.

The results were presented at the American College of Cardiology Conference in New Orleans and published in the New England Journal of Medicine.

TAVR Vs. Surgery

TAVR is offered as an option for patients who might be too old or too sick to undergo open-heart surgery. The procedure involves inserting a replacement valve through the groin, guiding it all the way to the heart, and then maneuvering it to the affected site.

However, the new study proves that the procedure would also be as safe and useful to younger and healthier patients.

Across 71 centers in the United States, the researchers recruited 1,000 patients who have severe aortic stenosis, a condition in which the heart valve narrows and prevents normal blood flow. Each patient had a low (less than 2 percent) operational risk.

Some of the patients underwent the traditional surgical aortic valve replacement while the others had TAVR.

A month after the procedure, the TAVR group saw fewer occurrences of stroke and new-onset atrial fibrillation than the surgery group. The TAVR group also had a shorter average hospital stay than the surgery group.

A year later, 68 patients or 15.1 percent from the surgery group had a stroke or was hospitalized or died due to heart-related problems or surgical complications compared to 42 patients (8.5 percent) in the TAVR group.

Safer And More Effective

"When TAVR was introduced, it was regarded as an alternative for patients who were too sick to undergo open-heart surgery," stated Martin B. Leon, a professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and the principal investigator of the trial. "Today's findings suggest that TAVR may be superior to surgery, even for patients with low operative risk."

The researchers, however, warned that the study has its limitations. The results only reflected the effects of TAVR after one year. The long-term durability of the replacement valve is still yet to be assessed.

However, the researchers added that they will continue observing the patients who had the procedure for at least 10 more years.

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