Valvular & structural heart diseaseMeta-analysis
Reinterventions After CoreValve/Evolut Transcatheter or Surgical Aortic Valve Replacement for Treatment of Severe Aortic Stenosis
- 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
| Outcome | adjusted subdistribution HR (95% CI) | P value | |
|---|---|---|---|
| Reintervention, Evolut vs CoreValve · 5 years · early | 0.30 (0.12–0.73) | ||
| Reintervention, Evolut vs CoreValve · 5 years · >1 to 5 years | 0.61 (0.21–1.74) | ||
| 0.10.31310Adjusted subdistribution hazard ratio (log scale) |
| Outcome | TAVR | SAVR | Evolut | CoreValve | Estimate | P value |
|---|---|---|---|---|---|---|
| Reintervention, Evolut vs CoreValve · 5 years | Not reported in the abstract | Not reported in the abstract | 0.9% | 1.6% | P = 0.006 | |
| Reintervention, Evolut vs SAVR · 5 years · similar | Not reported in the abstract | 1.5% | 0.9% | Not reported in the abstract | P = 0.41 |
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
Summarised from the published abstract; every number is checked against it