Seven-Year Study Shows Minimally Invasive, Open-Heart Valve Replacement Offer Similar Long-Term Outcomes

Hyderabad:A seven-year international study has found that both minimally invasive valve replacement and traditional open-heart surgery provide similar long-term outcomes for patients with severe aortic stenosis, offering important insights for India as it faces a growing burden of heart valve disease.

The research, published in ‘The New England Journal of Medicine’, followed nearly 1,000 patients with severe symptomatic aortic stenosis and compared two treatment approaches — transcatheter aortic valve replacement (TAVR), a minimally invasive procedure performed through a catheter, and surgical aortic valve replacement (SAVR), the conventional open-heart operation.

After seven years, the combined rate of death, stroke or heart-related rehospitalisation was 34.6 per cent in the TAVR group and 37.2 per cent in the surgery group, showing no statistically significant difference. More than 73 per cent of patients in both groups were alive and free of valve failure seven years after the procedure.

Dr Praveen Chandra, chairman, interventional cardiology, said that the findings provided strong evidence that both procedures offered durable and effective treatment for severe aortic stenosis. At seven years, death from any cause occurred in 19.5 per cent of patients who underwent TAVR compared with 16.8 per cent in the surgery group, while stroke rates were 8.5 per cent and 8.1 per cent, respectively. Rehospitalisation rates were 20.6 per cent in the minimally invasive group and 23.5 per cent among surgery patients.

Dr M. Gokul Reddy, senior consultant cardiologist, said the study strengthened confidence in minimally invasive valve replacement as a safe and effective alternative to open-heart surgery for many patients.

“TAVR offers several advantages, including smaller incisions, reduced surgical trauma, shorter hospital stays and faster recovery. Many patients are able to return to normal activities within days,” he said. He added that the procedure is particularly beneficial for elderly patients or those with multiple health conditions who may face higher risks with conventional surgery.

He also noted that the minimally invasive approach can reduce the need for prolonged intensive care and lower the risk of complications such as major bleeding or infections.

Dr O. Sai Satish, senior professor of cardiology, Nizam’s Institute of Medical Sciences (Nims), said TAVR was being used mainly for high-risk patients who may not be suitable candidates for open-heart surgery. “In many cases, Chief Minister's Relief Fund and Aarogyasri schemes help patients cover a significant part of the procedure cost Rs 10 lakhs,” he said.

Another senior doctor explained Gandhi Hospital and Osmania General Hospital are lacking in introducing TAVR yet.