Daijiworld Media Network – New Delhi
New Delhi, Mar 9: A major international study has found that two widely used treatments for severe aortic valve disease — minimally invasive valve replacement and traditional open-heart surgery — may provide similarly durable outcomes over the long term.
The research, published in the New England Journal of Medicine, followed around 1,000 patients suffering from Aortic Stenosis, a condition in which the heart’s aortic valve narrows and restricts blood flow.
The study compared results between patients undergoing Transcatheter Aortic Valve Replacement (TAVR), a minimally invasive procedure performed using a catheter inserted through a blood vessel, and those receiving conventional surgical valve replacement through open-heart surgery.
Researchers tracked patient outcomes over seven years and found that both treatment approaches produced comparable results in terms of survival and overall health.
According to the findings, the combined rate of death, stroke or heart-related rehospitalisation was 34.6 percent in the TAVR group and 37.2 percent among patients who underwent surgery — a difference researchers said was not statistically significant.
More than 73 percent of patients in both groups were alive and free of valve failure seven years after their procedure. The durability of implanted valves was also reported to be strong in both treatment categories.
In terms of specific outcomes, death occurred in 19.5 percent of patients treated with TAVR compared to 16.8 percent in the surgical group. Stroke rates were nearly identical at 8.5 percent and 8.1 percent respectively, while rehospitalisation rates stood at 20.6 percent for TAVR and 23.5 percent for surgery.
Praveen Chandra, chairman of interventional cardiology at Medanta in Gurugram, said the findings are significant for countries such as India where valve disease affects both younger and older populations.
“In India, we are no longer just managing valve disease; we are planning for a patient’s entire cardiac future,” Chandra said, adding that the new data provides confidence that both treatment strategies can deliver sustained benefits.
Doctors say India faces a unique dual burden of heart valve disease. Many younger patients suffer from Rheumatic Heart Disease caused by untreated infections that damage heart valves, particularly in rural and semi-urban areas. At the same time, hospitals in major cities are seeing more cases of age-related degenerative aortic stenosis.
Estimates suggest that between 1.5 and 2 per 1,000 Indians are affected by rheumatic heart disease, with more than two million people currently living with the condition.
The study also identified key differences between the two procedures. New-onset Atrial Fibrillation occurred more frequently after surgical valve replacement, affecting 43.5 percent of surgery patients compared to 17.7 percent of those treated with TAVR.
However, the need for a pacemaker was slightly higher among TAVR patients, with implantation required in 17.3 percent of cases compared with 12.8 percent in the surgical group.
Researchers emphasised that valve replacement should be seen as part of a long-term treatment journey rather than a one-time procedure, especially in countries where patients may live decades after their first intervention.
A final 10-year analysis of the study is expected in the coming years and will be closely watched by cardiologists worldwide. Experts say the findings offer reassurance that both treatment options can provide lasting benefits for patients suffering from severe aortic valve disease.