SPC365

Intra-hospital outcomes for TAVR under 75: can it hold a candle to SAVR?

Session: SESSÃO DE POSTERS 34 - TAVI 2
Speaker: João Reis Sabido

Congress: CPC 2025
Topic: H. Interventional Cardiology and Cardiovascular Surgery
Theme: 25. Interventional Cardiology
Subtheme: 25.3 Non-coronary Cardiac Intervention
Session Type: Cartazes
FP Number: ---
Authors: João Reis Sabido; Ana Abrantes; Miguel Azaredo Raposo; Catarina Gregório; Diogo Ferreira; Daniel Inácio Cazeiro; Tiago Rodrigues; Cláudia Moreira Jorge; Miguel Nobre Menezes; João Silva Marques; Pedro Carrilho Ferreira; Fausto J. Pinto

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Introduction</span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:11pt">In light of recently published studies supporting non-inferiority of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in low-risk patients, real-world evidence supporting the use of TAVR for younger patients&nbsp;under 75 years of age is still building.</span></span></span></span></p>

<p style="text-align:justify"><strong><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:11pt">Objective</span></span></span></span></strong></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:11pt">To compare in hospital outcomes of TAVR to surgical aortic valve replacement (SAVR) previously published results. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="color:black">Methods</span></span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:11pt"><span style="color:black">Retrospective single center study, analyzing a population of non-consecutive patients who underwent TAVR between 2014 and 2023, aged under 75 years. We compared the baseline characteristics and intra-hospital outcomes with results previously published with data from the German Quality Assurance Registry on Aortic Valve Replacement (AQUA), from a similar group of patients under 75 years of age, submitted do SAVR between 2013 and 2014<sup>1</sup>.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Results</span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:11pt">We analyzed a population of 113 patients&nbsp;submitted to TAVR. 57% were male, mean age was 69.8&plusmn;5.6 years. Regarding comorbidities, 87% had hypertension, 80% dyslipidemia, 55% diabetes <em>mellitus</em>, 32% chronic kidney disease, 22% peripheral arterial disease and 39% atrial fibrillation. 41% were at NYHA class II, and 55% class III at time of TAVR. Mean EuroSCORE was 2.4&plusmn;2.6. Ejection fraction was preserved in 68% of patients, with a mean of 53&plusmn;13 %, with 8% of patients having a LVEF of under 30%. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:11pt"><span style="color:black">Median admission time was shorter in </span>patients<span style="color:black"> who underwent TAVR, with 8.8&plusmn;9.9 days, comparing to 12.5&plusmn;10.7 days for SAVR. Intra-hospital death was similar, with 2.7% vs. 2%. Procedural related arterial vascular complications were more common in TAVR &ndash; &nbsp;8% vs. 1.3% - as was the need for permanent pacemaker implantation &ndash; 16% for TAVR vs. 3.5% for SAVR. Renal failure requiring dialysis and acute neurologic events were more common for </span>patients<span style="color:black"> who underwent SAVR &ndash; 1% vs. 5% and 1% vs. 2%, respectively. </span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="color:black">Conclusion</span></span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:11pt"><span style="color:black">Our findings suggest TAVR vs. SAVR in </span>patients<span style="color:black"> under 75 years may provide similar results to SAVR, with reduced in-hospital stay, acute kidney injury requiring dialysis and neurologic complications. Rate of pacemaker implantation and arterial vascular complications are, however, higher, as would be expected due to technical differences between techniques.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:9pt"><span style="color:black">1. Eggebrecht H, Bestehorn K, Rassaf T, Bestehorn M, Voigtl&auml;nder T, Fleck E, et al. In-hospital outcomes after transcatheter or surgical aortic valve replacement in younger patients less than 75 years old: a propensity-matched comparison. EuroIntervention. 2018 May;14(1):50&ndash;7. </span></span></span></span></span></p>