John K. Forrest MD, associate professor of medicine and director of the Interventional Cardiology and Structural Heart Disease programs at Yale School of Medicine, presented the three-year results from the Evolut Low-Risk Trial on March 5 at the American College of Cardiology (ACC) Annual Scientific Session. Forrest is the national co-principal investigator of the Evolut Low-Risk Trial and lead author of the study, published simultaneously in the Journal of the American College of Cardiology, which explores the durability of TAVR outcomes compared with surgical aortic valve replacement (SAVR) in patients at low surgical risk.
Patients with severe aortic stenosis who are at low surgical risk should continue to engage in shared decision making with their physicians concerning the risks and benefits of surgical versus transcatheter valve replacement.
John K. Forrest MD
Individuals with severe aortic stenosis, an abnormality that results in a narrowed aortic valve, have benefited from advances in structural heart disease. For thousands of patients, Transcatheter Aortic Valve Replacement or TAVR offers a less-invasive option to restore blood flow.
“This study shows that the initial benefit of TAVR remained broadly consistent over the first three years,” said Forrest in a related press release. “In patients who are at low risk for death, stroke, or other serious complications of aortic valve surgery, we need to have compelling evidence that TAVR is safe and effective and also that the results are durable. While we don’t know the five- and 10-year outcomes yet for these low-risk patients, we can be confident that the benefits of TAVR are durable at three years.”
As the eligibility for TAVR expands to younger, lower-risk patients, the Evolut Low Risk Trial shows reassuring trends for the treatment of severe aortic stenosis. After three years follow-up, 7.4% of those treated with TAVR had died or had a disabling stroke, compared with 10.4% of those treated with SAVR. In addition, rates of death, stroke, or readmission to the hospital were 13.2% for TAVR compared with SAVR at 16.8%.
“Patients with severe aortic stenosis who are at low surgical risk should continue to engage in shared decision making with their physicians concerning the risks and benefits of surgical versus transcatheter valve replacement,” said Forrest.
The 2023 ACC scientific sessions were held on Saturday, March 4 - Monday, March 6 at the Ernest N. Morial Convention Center in New Orleans. Visit cardiology.yale.edu for more ACC presentations from the Yale School of Medicine Section of Cardiovascular Medicine.