Five- Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.

Vinod H Thourani,Martin B Leon,Raj Makkar,Guido Ascione,Wilson Y Szeto,Mahesh V Madhavan,Susheel K Kodali,Rebecca T Hahn,Philippe Pibarot,S Chris Malaisrie,Samir R Kapadia,Mark J Russo,Howard C Herrmann,Vasilis Babaliaros,Robert Guyton,Philippe Genereux,David J Cohen,Brandon Park,Sarah Clarke,Marissa Gunnarsson,Molly Szerlip,Julien Ternacle,Jonathon Leipsic,Philipp Blanke,John G Webb,Craig R Smith,Michael J Mack

doi:10.1016/j.athoracsur.2024.11.025

Vinod H Thourani, Martin B Leon + Show 25 more

https://doi.org/10.1016/j.athoracsur.2024.11.025

Copy DOI

Export

Save

Cite

Abstract
Full-Text
Similar Papers

Abstract

Listen

Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). This study evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized Placement of Aortic Transcatheter Valves (PARTNER) 3 trial. In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, trileaflet AS and were followed up for 5 years. Patients were stratified into those undergoing isolated SAVR (n= 334; 73.6%) vs concomitant SAVR (n= 120; 26.4%). Short- and long-term morbidity was adjudicated by a Clinical Events Committee. Hemodynamic valve performance was evaluated by an echocardiographic core laboratory. Patient-reported health status was measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ). The mean age of participants was 73.6 ± 6.1 years; 71.1% of these patients were male. The median SAVR implant size was 23 mm overall. Five-year all-cause mortality (with vital status sweep) was 9.0% for all patients (8.5% isolated SAVR; 10.2% concomitant SAVR; P= .58), comparable to a recent analysis of low-risk isolated SAVR-treated patients in the STS database (overall mortality, 7.1%). The average 5-year mean gradient was 11.7 ± 5.6 mm Hg overall. Reintervention rates were low in both groups (isolated SAVR, 2.3% vs concomitant SAVR, 5.0%; P= .21), and most patients (isolated SAVR, 87.9%; concomitant SAVR, 86.1%) were alive with no evidence of bioprosthetic valve failure at 5 years. SAVR in low-risk patients in the PARTNER 3 trial demonstrated excellent 5-year outcomes. Five-year mortality was similar in patients undergoing isolated SAVR vs concomitant SAVR. This result was comparable to recently published national SAVR outcomes, thus demonstrating the generalizability of these findings.

Full Text