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PARTNER

PARTNER. The Transcatheter versus Surgical Aortic Valve Replacement in High Risk Patients with Severe Aortic Stenosis: The PARTNER Trial. Objective To compare surgical aortic valve replacement (AVR) with transcatheter aortic valve replacement (TAVR) in high-risk patients with severe stenosis

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PARTNER

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  1. PARTNER The Transcatheter versus Surgical Aortic Valve Replacement in High Risk Patients with Severe Aortic Stenosis: The PARTNER Trial Objective • To compare surgical aortic valve replacement (AVR) with transcatheter aortic valve replacement (TAVR) in high-risk patients with severe stenosis Study Design • Multicenter, randomized • 358 patients with severe aortic stenosis who were considered unsuitable candidates for surgery to standard medical therapy or transfemoral transcatheter implantation of a balloon-expandable bovine pericardial valve Primary Endpoint • 1-Year mortality rate from any cause

  2. PARTNER Secondary Endpoints Results • 1 year mortality 26.8% for AVR group vs 24.2% for TVR (HR, 0.93; 95% CI, 0.7 to 1.22; p=0.001 for noninferiority, p=0.62 for superiority) • 30-day neurological events were significantly higher in TAVR vs AVR groups (stroke or TIA, 5.5% vs 2.4%; p=0.04) • 1-year neurological events significantly higher in the TAVR group vs AVR (stroke or TIA, 8.3% vs. 4.3%; p=0.04) TAVR=transaortic valve replacement; AVR= aortic valve replacement; TIA=trans ischemic attack Defined as Rankin Score >2; this was a post hoc analysis.

  3. PARTNER Conclusions • The PARTNER trial is a groundbreaking study in the minimally invasive management of valvular heart disease, with the potential to change the standard of practice within cardiology • If preliminary results can be replicated with similar clinical effectiveness in routine practice, then transcatheter surgical AVR may be an acceptable alternative therapy to surgical AVR for high-risk patients in the near future • The significance of the trade-off between adverse events that are associated with TAVR versus surgical AVR short and long term requires further exploration

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