TAVR vs SAVR: rising expectations and changing indications for surgery in response to PARTNER II

Spadaccio, C., Nappi, F., Sablayrolles, J.-L. and Sutherland, F. W.H. (2017) TAVR vs SAVR: rising expectations and changing indications for surgery in response to PARTNER II. Seminars in Thoracic and Cardiovascular Surgery, 29(1), pp. 8-11. (doi: 10.1053/j.semtcvs.2017.01.008) (PMID:28684004)

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Despite the criticisms and concerns raised on the data published in the PARTNER II trial and related analyses, we are undeniably witnessing a revolution in the management of aortic valve disease, in which conventional full sternotomy surgical aortic valve replacement (SAVR), with all related complications and clinical burden, will soon become a nonviable option. Several of the findings described in the PARTNER II trial, although considerable as points of incongruence and study biases in comparison with SAVR, could be taken as lessons to found a new course in SAVR and redesign the respective roles of surgery and interventional procedures in aortic disease. In particular, the results of these trials can actually be considered as a stimulus to invest more effort to improve the current surgical practice that should embrace alternative solutions and least invasive approaches to provide a competitive advantage over percutaneous procedures. An analysis of these points in light of the more recent findings on transcatheter valve durability, thrombosis, and postprocedural complications is provided. Considerations on the parallel progress of SAVR and on the need for a behavioral change in the surgical community are discussed.

Item Type:Articles
Keywords:PARTNER II trial, minimally invasive surgery, surgical aortic valve replacement, transcatheter aortic valve replacement.
Glasgow Author(s) Enlighten ID:Spadaccio, Dr Cristiano
Authors: Spadaccio, C., Nappi, F., Sablayrolles, J.-L., and Sutherland, F. W.H.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Seminars in Thoracic and Cardiovascular Surgery
ISSN (Online):1532-9488
Published Online:22 February 2017

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