Long-term outcomes of transcatheter versus surgical aortic valve replacement in patients aged 70 years and older: An overlap-weighted analysis.
- 1Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
- 2Department of Critical Care Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
- 3Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Abstract
Objectives
To compare long-term outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients aged 70 to 89 years with aortic stenosis (AS).Methods
In this single-center retrospective study, 1100 patients who underwent primary TAVR (n = 599) or SAVR (n = 501) between 2008 and 2023 were included. An overlap-weighted propensity-score analysis was conducted using 36 baseline variables, including age, procedural year, frailty scale, Society of Thoracic Surgeons risk score, New York Heart Association class, history of coronary artery and cerebrovascular disease, and AS severity. The primary end point was the composite of all-cause mortality or cerebrovascular events.Results
During long-term follow-up, the composite end point occurred more frequently after TAVR than after SAVR. In the overlap-weighted analysis, TAVR was associated with a greater risk of the composite outcome (hazard ratio [HR], 1.8; 95% CI, 1.1-3.0; P = .024), with Kaplan-Meier curves diverging early and remaining separated. All-cause mortality did not differ between the groups (HR, 1.2; 95% CI, 0.7-2.1; P = .426); however, cerebrovascular events occurred predominantly after TAVR and remained significantly more frequent after overlap weighting (HR, 15; 95% CI, 2.8-89; P = .002).Conclusions
In the overlap-weighted population of patients aged 70 to 89 years with AS, SAVR and TAVR were associated with comparable all-cause mortality; however, cerebrovascular events occurred more frequently after TAVR.
Related
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BibTeX
@article{kutsuzawa2026longterm,
title = {{Long-term outcomes of transcatheter versus surgical aortic valve replacement in patients aged 70 years and older: An overlap-weighted analysis.}},
author = {Rieko Kutsuzawa and Naonori Kawamoto and Kimito Minami and Satoshi Kainuma and Kizuku Yamashita and Kota Suzuki and Takashi Kakuta and Ayumi Ikuta and Yuki Tadokoro and Yojiro Machii and Kentaro Mitsui and Shinichi Kurashima and Yuki Irie and Atsushi Okada and Kensuke Takagi and Makoto Amaki and Hideaki Kanzaki and Yasuhide Asaumi and Takeshi Kitai and Chisato Izumi and Satsuki Fukushima},
journal = {JTCVS open},
year = {2026},
month = jul,
doi = {10.1016/j.xjon.2026.101972},
url = {https://europepmc.org/article/MED/42948429},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Long-term outcomes of transcatheter versus surgical aortic valve replacement in patients aged 70 years and older: An overlap-weighted analysis.
AU - Rieko Kutsuzawa
AU - Naonori Kawamoto
AU - Kimito Minami
AU - Satoshi Kainuma
AU - Kizuku Yamashita
AU - Kota Suzuki
AU - Takashi Kakuta
AU - Ayumi Ikuta
AU - Yuki Tadokoro
AU - Yojiro Machii
AU - Kentaro Mitsui
AU - Shinichi Kurashima
AU - Yuki Irie
AU - Atsushi Okada
AU - Kensuke Takagi
AU - Makoto Amaki
AU - Hideaki Kanzaki
AU - Yasuhide Asaumi
AU - Takeshi Kitai
AU - Chisato Izumi
AU - Satsuki Fukushima
PY - 2026
DA - 2026/07/24
JO - JTCVS open
DO - 10.1016/j.xjon.2026.101972
UR - https://europepmc.org/article/MED/42948429
AB - Objectives To compare long-term outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients aged 70 to 89 years with aortic stenosis (AS).Methods In this single-center retrospective study, 1100 patients who underwent primary TAVR (n = 599) or SAVR (n = 501) between 2008 and 2023 were included. An overlap-weighted propensity-score analysis was conducted using 36 baseline variables, including age, procedural year, frailty scale, Society of Thoracic Surgeons risk score, New York Heart Association class, history of coronary artery and cerebrovascular disease, and AS severity. The primary end point was the composite of all-cause mortality or cerebrovascular events.Results During long-term follow-up, the composite end point occurred more frequently after TAVR than after SAVR. In the overlap-weighted analysis, TAVR was associated with a greater risk of the composite outcome (hazard ratio [HR], 1.8; 95% CI, 1.1-3.0; P = .024), with Kaplan-Meier curves diverging early and remaining separated. All-cause mortality did not differ between the groups (HR, 1.2; 95% CI, 0.7-2.1; P = .426); however, cerebrovascular events occurred predominantly after TAVR and remained significantly more frequent after overlap weighting (HR, 15; 95% CI, 2.8-89; P = .002).Conclusions In the overlap-weighted population of patients aged 70 to 89 years with AS, SAVR and TAVR were associated with comparable all-cause mortality; however, cerebrovascular events occurred more frequently after TAVR.
SN - 2666-2736
ER -