Transcatheter aortic valve replacement (TAVR) may be comparable in safety and efficacy to surgical aortic valve replacement (SAVR) in low-risk patients with aortic stenosis.

The catheter-based TAVR procedure—which involves implanting a new valve in the heart by passing it through a blood vessel in the chest or groin—is often less invasive and results in shorter recovery time than SAVR. Although current U.S. guidelines recommend TAVR in older high-risk patients, previous research has not resulted in a consensus on the optimal procedure for younger low-risk patients.

In the DEDICATE-DZHK6 trial, results of which were presented by Seiffert et al at the American College of Cardiology (ACC) Annual Scientific Session 2024 and simultaneously published in The New England Journal of Medicine, researchers randomly assigned 1,414  patients with severe, symptomatic aortic stenosis to undergo valve replacement with either TAVR or SAVR. To imitate real-world conditions, the local interdisciplinary teams performing the procedures determined patient eligibility based on inclusion criteria and selected which replacement valves to use by considering patients’ individual anatomical and medical factors.

Patients who underwent TAVR had a 47% lower risk of strokes or mortality after 1 year compared with those who underwent SAVR. The patients in the TAVR group were also less likely to experience all-cause mortality or disabling strokes compared with those in the SAVR group.

The researchers plan to examine the substantial differences in the risk of adverse outcomes between TAVR and SAVR in future trials.