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Randomised controlled trial
At 5 years, transcatheter aortic valve replacement had similar rates of mortality and stroke as surgical aortic valve replacement in high-risk patients
  1. Michael J Reardon1,
  2. Neal S Kleiman2
  1. 1Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA;
  2. 2Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
  1. Correspondence to: Dr Michael J Reardon, Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Suite 1401, Houston, TX 7703, USA; mreardon{at}houstonmethodist.org

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Context

When calcific aortic stenosis is associated with symptoms, particularly congestive heart failure, it is also associated with a risk of death when not corrected surgically. Unfortunately, the frequency of the disease increases with age and patients who are most likely to have it are those who are at highest risk for open cardiac surgery. Transcatheter aortic valve replacement (TAVR) is an emerging treatment that is considerably less invasive than surgical aortic valve replacement (SAVR). The PARTNER investigators compared TAVR to conservative medical therapy in patients who were not candidates for SAVR (Kapadia and colleagues) and compared TAVR to SAVR in patients who were at high risk for SAVR (Mack and colleagues).

Methods

Two studies were performed as part of the PARTNER programme. Inclusion criteria were identical with the exception of perceived surgical risk. In Kapadia and colleagues study, two cardiovascular surgeons and an interventional cardiologist had to agree that …

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