In women with symptomatic, severe aortic stenosis (AS), TAVR with the balloon-expandable valve was superior to surgical aortic valve replacement in terms of the composite rate of death, stroke and rehospitalization at one-year follow-up, according to a pooled analysis of patient-level data from RHEIA and PARTNER 3 trials presented at TCT 2024.

Researchers examined 30-day and one-year clinical outcomes in women with severe AS who were enrolled in the RHEIA and PARTNER 3 trials and had undergone TAVR with a balloon-expandable valve or surgery, with the goal helping to guide clinical decision-making and better assessing outcomes in women.

In addition to superiority of TAVR regarding the composite endpoint, which was largely driven by lower rates of rehospitalization, researchers said low rates of reintervention, endocarditis and thrombosis were observed in both treatment groups. Additionally, an interaction analysis did not reveal a different effect of treatment type on outcomes based on annular size (small vs. large) or age (≤75 vs. >75 years).

In other findings, researchers noted excellent hemodynamics and echocardiographic assessments with both procedures, with 99% patients having none/trace or mild paravalvular aortic regurgitations at 30 days and 1 year. Thirty-day mean gradients were also low and sustained out to one year.

"We report the largest all-female analysis in symptomatic, severe AS patients exploring the relative treatment effects of TAVR vs. surgery during the first year after therapy," said Didier Tchetche, MD, who presented the findings. "In women with symptomatic, severe AS, TAVR using balloon-expandable devices may be the preferred therapeutic option over surgery."