Boston Scientific Corp. presented late-breaking data at EuroPCR 2021 demonstrating positive procedural performance for its Acurate Neo2 aortic valve system, including low rates of paravalvular leakage (PVL) and permanent pacemaker implementation (PPI). The findings are good news, following the older Acurate Neo’s failure to demonstrate noninferiority to Medtronic plc’s Evolut R in the so-called SCOPE II study.
Two-year results from the Evolut Low Risk Trial show Medtronic plc’s Evolut transcatheter aortic valve replacement (TAVR) is noninferior to open-heart surgery in younger, healthier aortic stenosis patients. Moreover, the Evolut cohort fared better on certain critical events. Specifically, two-year rates of all-cause mortality or disabling stroke were 4.3% for TAVR patients vs. 6.3% for those undergoing surgical aortic valve repair (SAVR).
Much of the noise surrounding transcatheter aortic valve replacement (TAVR) vs. its surgical counterpart has to do with residual paravalvular leak. However, a new paper in the Journal of the American College of Cardiology (JACC) seems to have overwritten that consideration. The underlying registry study indicates that procedural success and outcomes at one year are superior in TAVR to in SAVR – yet another piece of evidence that seemingly tips the scales even more toward TAVR devices.