CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

November 11th, 2011

Transapical TAVR on the Ropes: Is It Down for the Count?

and

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

  1. Transapical TAVR provided no increase (and even a possible decrease) in quality of life compared to AVR; and
  2. 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? 

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One Response to “Transapical TAVR on the Ropes: Is It Down for the Count?”

  1. Leon Hyman, Ms M.D. says:
    November 13, 2011 at 9:33 pm

    Symptomatic aortic stenosis is a highly and rapidly lethal disease, therefore why use a procedure(TAVR)that is is less effective,and more costly than AVR. TAVR is not the holy grail. AVR obviously has it’s risks, but so does getting into your car and driving to the Doctor to find out what to do about the symptoms you’re having from your scrooge like aortic valve.

    Competing interests pertaining specifically to this post, comment, or both:
    none