A minimally invasive procedure helps improve symptoms and quality of life for nearly 2 in 3 patients with aortic stenosis, based on a recent analysis of a national registry of patients undergoing transcatheter aortic valve replacement.
Published in JAMA Cardiology, this study looked at short- and long-term outcomes in patients undergoing transcatheter aortic valve replacement.
Transcatheter aortic valve replacement, often referred to as TAVR, is a minimally invasive procedure used to treat aortic stenosis, which occurs when the heart’s aortic valve narrows. TAVR is typically reserved for patients who are too risky for surgery, in an effort to relieve symptoms and improve outcomes. But compared with surgery, TAVR is still a relatively new treatment for aortic stenosis and more research is needed to track its safety and efficacy.
To provide an update, researchers analyzed data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry, which tracks U.S. patients with severe aortic stenosis undergoing TAVR.
The recent analysis included more than 31,600 patients that underwent TAVR between 2011 and 2016 at more than 450 clinical sites across the United States. Upon enrollment and one month after their procedure, participants completed questionnaires to assess their symptoms and quality of life. Roughly 7,000 of participants also repeated the assessment at one year to help track long-term outcomes.
Most patients were between the ages of 78–88 years old, and roughly half were women.
After analysis, researchers found that TAVR was associated with significant improvements in patients’ quality of life. Prior to the participant’s procedure, the average quality of life score was 42, based on a scale of 0–100. Following the procedure, the average quality of life scored increased by 28 points after one month and by 32 points after one year among surviving participants. Overall, just over 62% of patients had a positive outcome and reasonable quality of life after one year.
However, the study found that patients with poorer health, older age, and existing conditions like diabetes and a history of stroke saw less improvement than healthier individuals. Among patients with very poor health or serious conditions like lung disease, chances that quality of life improved after TAVR was about 50/50.
Based on findings, experts hope to fine-tune exactly which patients are most appropriate for TAVR. It’s clear that TAVR can help significantly improve outcomes in many patients, particularly in those that are lower risk. However, this study found that approximately 1 in 3 patients still had a poor outcome one year after TAVR. Moving forward, experts hope to boost positive outcomes by offering TAVR to patients that stand to benefit most from the procedure.