Summary of the article PARNER, the cohort Presented at the ACC 15 congress, which changes the results in 5 years of percutaneous aortic valve implantation in comparison with conventional valve surgery for severe aortic stenosis.
The results of a 5-year follow-up of the PARTNER cohort A study showed that the implantation of percutaneous aortic valve (TAVR) in patients with high surgical risk aortic stenosis had similar clinical results to conventional aortic valve replacement.
The patients of the cohort A were patients who had a high surgical risk, defined by a STS score> 10 the mortality predicted in 30 days> 15%. Recalling that the study was also carried out with cohorte B, which was carried out with patients who could not undergo surgery (mortality in 30 days> 50%) – check this link
In PARTNER cohort A, mortality was 67.8% in the TAVR group and 62.4% in the surgical group (p not significant).
As for cerebrovascular accident lasts, there is an initial increase in the TAVR group. In 2 years, these tasas started to converge, and in the hub they differ between the 2 groups after 5 years of tracking.
Also hubo signs of deterioration of the valve structure. In spite of this, the paravalvar escape table was the largest in the TAVR group. Moderate to severe aortic insufficiency is documented in 14% of patients in the TAVR group and in 1% in the surgical group. The paravalvular leak is associated with a higher mortality.
The studio was realized with first generation Sapien prostheses (Edwards Lifesciences).
This result gives indication of surgical valve replacement as standard treatment for patients with high surgical risk aortic stenosis.
References: Mack MJ, Leon MB, Smith CR, et al. Five-year outcomes of transcatheter aortic valve replacement or surgical valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): A randomized controlled trial. Lancet 2015; DOI: S0140-6736 (15) 60308-7