During the Top Adult Cardiac Surgery Abstracts session on Sunday, Jan. 25, J. Hunter Mehaffey, MD, a cardiothoracic surgeon from West Virginia University, will examine results comparing two treatment options— Transcatheter vs. Surgical Aortic Valve Replacement in Medicare Beneficiaries with Aortic Stenosis and Significant Coronary Disease. The study aimed to assess the relative benefits of a surgical approach with CABG/SAVR vs a transcatheter approach with TAVR/PCI (elective +/- 3 months) and safety of these procedures, focusing on early and late outcomes such as mortality, complications, and hospital readmissions.
Dr. Mehaffey’s presentation will highlight the study’s findings that TAVR/PCI is associated with lower hospital mortality, bleeding, and kidney injury but higher incidence of new pacemaker and vascular complications compared to SAVR in this patient group. However, CABG/SAVR was associated with significantly lower longitudinal all-cause mortality and improved freedom from the composite of death, stroke, MI, or valve reintervention. Furthermore, subgroup analysis of single vessel coronary patients confirmed CABG/SAVR was associated with superior freedom from the composite of death, stroke, MI, or valve reintervention compared to PCI/TAVR particularly in surgical patients who received arterial grafts.
This study uses real-world contemporary data highlighting the longitudinal benefits of a surgical approach compared to a transcatheter approach in patients undergoing aortic valve replacement with significant coronary disease. “These data provide important information to guide heart team discussion and decision making in patients needing aortic valve replacement,” said Dr Mehaffey.