ESC 24 Hot Line Discussion: RHEIA: TAVR vs SAVR in Women with Severe AS

Transcatheter aortic valve replacement shows superiority over surgical aortic valve replacement for women with severe aortic stenosis.
Host, Dr Harriette Van Spall (McMaster University, CA) sits down with Prof Helene Eltchaninoff (University Hospital of Rouen, FR) to discuss key findings from the RHEIA trial (NCT04160130; Optimapharm).
This prospective, randomised study aims to compare the safety and efficacy of Transcatheter Aortic Valve Implantation (TAVI) versus Surgical Aortic Valve Replacement (SAVR) in women with severe symptomatic aortic stenosis. 432 patients across 48 locations from Europe were randomised 1:1 to receive either procedure. The trial followed patients for 1 year to assess outcomes, with a focus on comparing the two treatments in this specific patient population.
Investigators found that in women all-comers with severe aortic stenosis, TAVI with the Edwards Sapien 3 or Sapien 3 Ultra was superior to surgery for the primary composite endpoint of death, stroke, or rehospitalisation at one year. This was primarily driven by a lower rate of rehospitalisations. TAVI was found to have a lower incidence of new onset AF at 30 days, quicker recovery and a shorter hospital stay, but higher rates of paravalvular aortic regurgitation and new permanent pacemaker implantation.
Recorded remotely from Rouen and Hamilton, 2024.
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