Long-term outcomes of transcatheter versus surgical aortic valve replacement in patients aged 70 years and older: An overlap-weighted analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objectives To compare long-term outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients aged 70 to 89 years with aortic stenosis (AS). Methods In this single-center retrospective study, 1100 patients who underwent primary TAVR (n = 599) or SAVR (n = 501) between 2008 and 2023 were included. An overlap-weighted propensity-score analysis was conducted using 36 baseline variables, including age, procedural year, frailty scale, Society of Thoracic Surgeons risk score, New York Heart Association class, history of coronary artery and cerebrovascular disease, and AS severity. The primary end point was the composite of all-cause mortality or cerebrovascular events. Results During long-term follow-up, the composite end point occurred more frequently after TAVR than after SAVR. In the overlap-weighted analysis, TAVR was associated with a greater risk of the composite outcome (hazard ratio [HR], 1.8; 95% CI, 1.1-3.0; P = .024), with Kaplan-Meier curves diverging early and remaining separated. All-cause mortality did not differ between the groups (HR, 1.2; 95% CI, 0.7-2.1; P = .426); however, cerebrovascular events occurred predominantly after TAVR and remained significantly more frequent after overlap weighting (HR, 15; 95% CI, 2.8-89; P = .002). Conclusions In the overlap-weighted population of patients aged 70 to 89 years with AS, SAVR and TAVR were associated with comparable all-cause mortality; however, cerebrovascular events occurred more frequently after TAVR.
Source: JTCVS Open
Authors: Rieko Kutsuzawa, Naonori Kawamoto, Kimito Minami, Satoshi Kainuma, Kizuku Yamashita, Kota Suzuki, Takashi Kakuta, Ayumi Ikuta, Yuki Tadokoro, Yojiro Machii, Kentaro Mitsui, Shinichi Kurashima, Yuki Irie, Atsushi Okada, Kensuke Takagi, Makoto Amaki, Hideaki Kanzaki, Yasuhide Asaumi, Takeshi Kitai, Chisato Izumi, Satsuki Fukushima
Institution: National Cerebral and Cardiovascular Center
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,431
OpenAlex ID: W7170700838