Among patients with severe isolated aortic stenosis younger than 65, the rate of transcatheter aortic valve replacement (TAVR) now almost matches that of surgical aortic valve replacement (SAVR) despite guideline recommendations to the contrary, a study in a national US population shows.
The 2020 American Heart Association/American College of Cardiology (AHA/ACC) valve guideline recommends SAVR for patients younger than 65 with severe aortic stenosis, the researchers note, but their study showed "near equal utilization between TAVR and SAVR in these younger patients by 2021," at 48% and 52% respectively.
Toishi Sharma, MD, and colleagues presented these findings in an oral poster session at Transcatheter Cardiovascular Therapeutics 2022, and the study was simultaneously published today as a Research Letter in the Journal of the American College of Cardiology (JACC).
"To our knowledge, the current findings represent the first national temporal trends study stratifying [aortic stenosis] therapies according to guideline-recommended age groups: our observations demonstrate the dramatic growth of TAVR in all age groups, including young patients," the researchers conclude.
They analyzed changes in rates of TAVR and SAVR in a US sample stratified by age: younger than 65 years, 65 to 80, and older than 80 years.
These findings have implications for lifetime management of younger patients who undergo TAVR, they write, "including issues related to lifetime coronary access, valve durability and the potential for subsequent TAVR procedures over time."
