November 11th, 2011
Transapical TAVR on the Ropes: Is It Down for the Count?
STACCATO showed more adverse events with transapical transcatheter aortic valve replacement (TAVR) than with aortic valve replacement (AVR) in low risk, elderly patients.
In patients with severe, symptomatic aortic stenosis who are believed to have high surgical risk, PARTNER substudy results presented at the AHA show
- Transapical TAVR provided no increase (and even a possible decrease) in quality of life compared to AVR; and
- Transapical TAVR increased procedural, index admission, and 12 month costs (by ~$10,000/patient) when compared to AVR.
In short, the results of these studies are consistent.
What is the problem? Is it the procedure, the equipment, or the training? Should we stop the fight and throw transapical TAVR out of the ring?