Data presented at the 2016 Transcatheter Cardiovascular Therapeutics (TCT) meeting (29 October–2 November, Washington, DC, USA) indicate that intermediate-risk patients who undergo transcatheter aortic valve implantation (TAVI) with a Sapien XT or Sapien 3 device (Edwards Lifesciences) have significantly better quality of life at 30 days compared with those who undergo surgical aortic valve replacement. However, according to these data, there were no significant differences in quality of life between TAVI and surgery patients at one year.
The new data, involving more than 3,000 patients enrolled in The PARTNER II trial, showed improvements in cardiovascular health status—as well as overall physical and mental well-being— after TAVI with the Edwards Sapien XT and Sapien 3 valves. These health benefits with were early and sustained (30 days and one year, respectively). Overall, 71.1% of patients treated with transfemoral TAVI experienced health status improvements at one month compared with just 44.7% of patients treated surgically. Moreover, when mortality and the extent of quality of life improvement were evaluated together, transfemoral TAVI with the Sapien XT valve was superior to surgery at the one- and two-year follow-up, as well. However in the transthoracic cohorts, mortality and quality of life benefits were similar to that of surgery.
David Cohen (University of Missouri-Kansas City and Director of Cardiovascular Research at Saint Luke’s Mid America Heart Institute, USA), who presented the data at TCT, comments: “Because aortic stenosis patients are generally elderly and often have multiple comorbid conditions, many of them care more about maintaining or improving their quality of life rather than simply achieving a longer life. Taken together with previous data demonstrating very low mortality and disabling stroke rates with transfemoral TAVI among patients at intermediate surgical risk, these findings demonstrate that, for such patients, TAVI provides both early and late benefits that are important from the patient’s perspective.”
Read TAVI at the end of life: Knowing when it is futile by David Cohen and Suzanne Arnold