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

Keywords

acute kidney failure, adult, aged, all cause mortality, aortic valve replacement, artificial heart pacemaker, cerebrovascular accident, cohort analysis, complication, conference abstract, female, heart infarction, hospitalization, human, major bleeding, major clinical study, male, middle aged, mortality risk, pacemaker implantation, propensity score, retrospective study, transcatheter aortic valve implantation, valvular heart disease

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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