TCT-1100 Transcatheter Versus Surgical Aortic Valve Replacement in Patients Aged 50 to 65 Years: A Propensity Score-Matched Retrospective Study

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: Transcatheter aortic valve replacement (TAVR) is increasingly considered for younger patients, yet data comparing outcomes versus surgical AVR (SAVR) in those aged 50–65 years remain limited. Methods: We conducted a retrospective study of patients aged 50–65 years undergoing TAVR or SAVR using the TriNetX database. Propensity score matching (1:1) minimized the effects of baseline differences. Outcomes included a composite of all-cause mortality and stroke, permanent pacemaker implantation (PPM), acute kidney injury (AKI), major bleeding, and myocardial infarction at 30 days. Additional one- and five-year outcomes included all-cause hospitalization, valve degeneration and thrombosis, and redo AVR. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate the overall effect size. Results: A total of 1698 matched pairs were analyzed. At 30 days, TAVR was associated with a lower risk of the mortality/stroke (HR 0.63; 95%CI 0.46–0.86), major bleeding (HR 0.16; 95%CI 0.13–0.19), and AKI (HR 0.50; 95%CI 0.38–0.65). At 1 year, TAVR had a higher risk of individual all-cause mortality (HR 1.46; 95%CI 1.09–1.94) with no difference in the composite outcome. At 5 years, TAVR showed a higher risk of mortality/stroke (HR 1.50; 95%CI 1.27–1.78; Figure) and valve degeneration (HR 1.81; 95%CI 1.43–2.28), with no difference in hospitalization or redo AVR. [Formula presented] Conclusion: In patients aged 50–65 years, TAVR was associated with fewer short-term complications. However, at 1 year, mortality was higher with TAVR, and by 5 years, the risks of mortality/stroke and valve degeneration increased in comparison to SAVR. Categories: STRUCTURAL: Valvular Disease and Intervention: Aortic

Volume

86

Issue

17

First Page

B469

Last Page

B470

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