The Particulars: Previous research indicates that favorable results can be achieved with transcatheter aortic valve replacement (TAVR) in high-risk patients use either the transfemoral or transapical approach. Whether these results are reproducible in a real-world setting has not been determined.
Data Breakdown: A nonrandomized cohort of the PARTNER (Placement of AoRtic TraNscathetER valve) trial found significantly lower 30-day, in-hospital rates of stroke, stroke/transient ischemic attack (TIA), major vascular injury, and valve embolization than found in the randomized trial in patients who underwent TAVR using the transapical approach. With the transfemoral approach, patients in the nonrandomized cohort had lower rates of 30-day, in-hospital stroke and TIA. With both approaches, 1-year outcomes favored those in the nonrandomized cohort.
Take Home Pearl: It appears that the favorable results achieved with TAVR in high-risk patients in the randomized PARTNER trial are reproducible in a real-world setting.