Aortic Valve (TAVR/TAVI)Wednesday, May 27, 2026

Clinical outcomes following transcatheter aortic valve replacement in patients with concordant versus discordant aortic stenosis.

1 min read·By E. Nolan Beckett, MD·Source: American heart journal plus : cardiology research and practice

Key Numbers

50% from 2012 to 2022

53% were female

95% CI

14.5% vs 10

From The Valve Wire

The TAVR-explant problem is now a number we can quote at heart team meetings. [NOTABLE] A narrative review of four studies and 35,677 patients pegs operative mortality of redo SAVR after TAVR at 12-17% versus 1.1-9% after prior SAVR , with propensity-matched odds ratios as high as 12.5 and observed-to-expected ratios exceeding 1.0 even in low-risk patients.

TAVR-SAVR volume is growing at up to 144.6% annually and may eclipse SAVR-SAVR by 2029.

Editor’s take pending for this article; this is the section commentary excerpt.

Source Abstract

STUDY OBJECTIVE: This study aimed to evaluate clinical outcomes of patients with symptomatic discordant (aortic stenosis) AS following transcatheter aortic valve replacement (TAVR). DESIGN: This is a retrospective cohort study. SETTING: Patients who underwent a TAVR for severe symptomatic native AS with preserved left ventricular ejection fraction ≥50% from 2012 to 2022 at our institution were included. PARTICIPANTS: Patients were divided into two cohorts, concordant AS (met all AS criteria) and discordant AS (< 3 criteria). INTERVENTIONS: TAVR. MAIN OUTCOMES MEASURES: The primary endpoint was all cause mortality and secondary outcomes were hospital readmissions for myocardial infarction (MI) and stroke. RESULTS: This study evaluated 2021 patients; the median age was 82.6 (77.0-87.2) years, and 53% were female. There was no difference in long-term mortality between discordant or concordant AS (HR: 0.89 [95% CI: 0.77-1.02]; P = 0.09). However, the discordant group had a higher 1-year mortality rate than the concordant group (14.5% vs 10.1%, respectively; P = 0.0054) and comparable mortality rates at 5 years (52.0% vs 50.5%, respectively; P = 0.18). The long-term readmission rate for MI was higher for the discordant group (HR: 0.47 [95% CI: 0.27-0.80]; P = 0.005), and there was no difference in readmission for stroke or transient ischemic attack (HR: 1.33 [95% CI: 0.92-1.94]; P = 0.133). CONCLUSIONS: Patients with symptomatic severe AS with discordant echocardiographic findings may have similar survival outcomes than those with concordant AS after undergoing TAVR.

Authors: Hundal P, Abood Z, Zlochiver V, Boulware D, Osman M et al.

Read the Original

Full article at American heart journal plus : cardiology research and practice

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The Valve Wire summarizes; we link out to primary sources for verification.