Valvular & structural heart disease

Reinterventions After CoreValve/Evolut Transcatheter or Surgical Aortic Valve Replacement for Treatment of Severe Aortic Stenosis

JACC Cardiovasc IntervPublished Pooled analysis of randomised trials and single-arm studies

Authors' conclusion

A low incidence of reintervention was observed for CoreValve/Evolut R/PRO and SAVR through 5 years.

Study context

Population
Patients with severe AS treated with CoreValve/Evolut transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) in Medtronic trials and single-arm studies99 reinterventions
Participants
5,925 / 1,832 / 1,447 / 4,478
Comparison
CoreValve/Evolut TAVR vs SAVR
  • TAVRn = 5,925
  • SAVRn = 1,832reference
  • Evolutn = 1,447
  • CoreValven = 4,478
Outcome
Cumulative incidence of valve reintervention
Follow-up
5 years

Pooled result

As reported in the abstract

Reintervention through 5 years
TAVR vs SAVRAdjusted subdistribution hazard ratio (95% CI)
Early (≤1 year)
3.50(1.53–8.02)
>1 to 5 years
1.05(0.48–2.28)

Further pooled results

OutcomeAdjusted subdistribution HR (95% CI)
Reintervention, Evolutvs CoreValve · 5 yearsEarly0.30 (0.12–0.73)
Reintervention, Evolutvs CoreValve · 5 years>1 to 5 years0.61 (0.21–1.74)
OutcomeSAVREvolutCoreValveP value
Reintervention, Evolut vs CoreValve · 5 years— not stated in the abstract0.9%1.6%P = 0.006
Reintervention, Evolut vs SAVR · 5 yearsSimilar1.5%0.9%— not stated in the abstractP = 0.41

— not stated in the abstract

Most common reason for reintervention

Paravalvular regurgitation after TAVR; endocarditis after SAVR

Original publication

Reinterventions After CoreValve/Evolut Transcatheter or Surgical Aortic Valve Replacement for Treatment of Severe Aortic Stenosis. JACC Cardiovasc Interv. Published 3 April 2024. doi:10.1016/j.jcin.2024.01.292

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