🫀 TAVR mortality was 1.4% vs 3.7% with SAVR
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In a National Readmission Database study of 361,875 patients with aortic stenosis treated from 2016 to 2020, in-hospital mortality was 1.4% with TAVR vs 3.7% with SAVR. Adjusted analysis found SAVR was associated with significantly higher odds of death than TAVR (OR 2.66, 95% CI 2.51-2.81), while an AI XGBoost model identified liver failure and kidney dysfunction as key mortality predictors.
Why It Matters To Your Practice
For clinicians weighing valve strategy, this large real-world analysis suggests TAVR was associated with lower in-hospital mortality than SAVR.
The findings may be especially relevant when counseling older or higher-risk patients in whom peri-procedural risk is a major concern.
AI-based risk modeling also points to end-organ dysfunction as a practical signal for closer pre-procedure assessment.
Clinical Implications
TAVR may offer a short-term survival advantage during the index hospitalization compared with SAVR.
Pre-procedure evaluation should pay close attention to liver failure and renal dysfunction, which were linked to higher mortality risk.
Heart teams can use these data to sharpen shared decision-making, particularly when procedural invasiveness and acute risk are central issues.
Insights
The study followed STROBE principles and used NRD data from 2016-2020, capturing broad U.S. inpatient practice patterns.
The cohort was nearly evenly split: 182,443 patients underwent TAVR and 179,432 underwent SAVR.
Because this was an observational cross-sectional analysis, the results show association rather than proof that TAVR causes lower mortality.
The Bottom Line
In this large database study, TAVR was associated with substantially lower in-hospital mortality than SAVR for aortic stenosis.
For practice, the key AI-relevant takeaway is that machine-learning risk tools may help flag patients with organ dysfunction who need more careful procedural planning.
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