• Suzanne J Baron, Vinod H Thourani, Susheel Kodali, Suzanne V Arnold, Kaijun Wang, Elizabeth A Magnuson, Augusto D Pichard, Vasilis Babaliaros, Isaac George, D Craig Miller, E Murat Tuzcu, Kevin Greason, Howard C Herrmann, Craig R Smith, Martin B Leon, David J Cohen, and PARTNER 2 Investigators.
• Saint Luke's Mid America Heart Institute, Kansas City, Missouri. Electronic address: sbaron@saint-lukes.org.
• JACC Cardiovasc Interv. 2018 Jun 25; 11 (12): 1188-1198.

ObjectivesThe aim of this study was to evaluate whether transcatheter aortic valve replacement (TAVR) with the SAPIEN 3 valve (S3-TAVR) results in improved quality of life (QoL) compared with previous-generation TAVR devices or surgical aortic valve replacement (SAVR).BackgroundIn patients with severe aortic stenosis at intermediate surgical risk, TAVR using the SAPIEN XT valve (XT-TAVR) results in similar QoL compared with SAVR. Compared with SAPIEN XT, the SAPIEN 3 valve offers a lower delivery profile and modifications to reduce paravalvular regurgitation.MethodsBetween February and December 2014, 1,078 patients at intermediate surgical risk with severe aortic stenosis were treated with S3-TAVR in the PARTNER S3i (Placement of Aortic Transcatheter Valve) trial. QoL was assessed at baseline, 1 month, and 1 year using the Kansas City Cardiomyopathy Questionnaire, Medical Outcomes Study Short Form-36, and EQ-5D. QoL outcomes of S3-TAVR patients were compared with those in the SAVR and XT-TAVR arms of the PARTNER 2A trial using propensity score stratification to adjust for differences between the treatment groups.ResultsOver 1 year, S3-TAVR was associated with substantial improvements in QoL compared with baseline. At 1 month, S3-TAVR was associated with better QoL than either SAVR or XT-TAVR (adjusted differences in Kansas City Cardiomyopathy Questionnaire overall summary score 15.6 and 3.7 points, respectively; p < 0.001). At 1 year, the differences in QoL between S3-TAVR and both SAVR and XT-TAVR were reduced but remained statistically significant (adjusted differences 2.0 and 2.2 points, respectively; p < 0.05). Similar results were seen for generic QoL outcomes.ConclusionsAmong patients at intermediate surgical risk with severe aortic stenosis, S3-TAVR resulted in improved QoL at both 1 month and 1 year compared with both XT-TAVR and SAVR.Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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