TAVI enthusiasm should be “tempered” in low-risk patients whilst durability concerns remain

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Philippe Pibarot (Québec, Canada) talks to BLearning Cardio at PCR London Valves 2019 (17–19 November, 2019; London, UK) about the main data findings in the PARTNER 2 trial which evaluated more than 2,000 intermediate-risk patients with severe aortic stenosis who either underwent a TAVI procedure or surgical aortic valve replacement (SAVR).

There were “no major red flags” from the data says Pibarot, who adds however, that that the SAPIEN XT (second generation device) had lower durability at five years compared to surgery which was “somewhat disappointing”.

On the other hand, the third generation SAPIEN 3 showed similar durability to surgery at five years. He explains that although he was expecting greater durability in the third generation device, the amount of difference “surprised me”. Pibarot delves into why this was the case and looks at some of the main design differences between the two iterations.

Pibarot concludes by discussing the future of TAVI and the in particular the move to low-risk patients. He believes that physicians need to “temper our enthusiasm” of using TAVI in this patient group until there is “an established record for durability”.

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