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Apr 17, 2014

Head-to-Head Comparison of Heart Valves

New research clarifies which type of valve replacement device is most effective in treating patients with severe aortic stenosis.

Not all valves are created equal when it comes to transcatheter aortic valve replacement (TAVR), according to research presented at the American College of Cardiology’s 63rd Annual Scientific Session.

This study compared two types of TAVR devices: the balloon-expandable valve vs. the self-expandable valve. TAVR is a minimally-invasive procedure used to treat aortic stenosis, or narrowing of the heart valve opening. Both types of valves can be used to replace faulty valves, but no one has ever compared them directly to determine whether one is more safe or effective than the other—until now.

Through the CHOICE trial, researchers randomly assigned 241 patients to receive either the balloon-expandable valve or the self-expandable valve during their TAVR procedure. All study participants had severe aortic stenosis and were too high-risk for surgery, which is why TAVR was the best treatment option.

After following patients for 30 days after their procedure, researchers found that balloon valves performed better than the self-expandable valves in a few ways. The procedure was considered successful in 96% of the patients receiving the balloon valve, compared to only 76% of patients in the self-expandable group. The balloon valve also carried slightly lower risk of complications and death than the self-expandable valve, which is promising.

As the first trial comparing these two types of heart valves, experts are glad to have evidence showing that one type of valve performs better than the other. In general, both types of valves are effective in treating narrowed heart valves but until now, it was unclear if one was better than the other. Still, experts push for further research comparing balloon and self-expandable valves during TAVR. Since the CHOICE study only followed patients for a month, authors hope for more long-term trials that compare the two devices. They also hope that future research will help continually improve these revolutionary devices to help make TAVR as safe and effective as possible.

Questions for You to Consider

  • What is aortic stenosis and how does it progress over time?

  • Aortic stenosis occurs when the aortic valve does not open fully, which can obstruct normal blood flow and put extra stress on the heart. Aortic stenosis can start out mild, but worsen over time as the area of the aortic valve decreases lessening the amount of blood flowing from the heart. Patients with aortic stenosis should be continually monitored by a cardiologist to track the progression of this condition, and strenuous activity should be avoided in those with moderate to severe aortic stenosis.
  • How is aortic stenosis treated?
  • Treatment for aortic stenosis varies depending on how severe the condition is. If aortic stenosis is mild and causes no symptoms, patients may only be monitored over time. However, patients with more severe aortic stenosis often require medication, surgery or minimally-invasive procedures to repair or replace the valve and relieve symptoms.

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