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Transcatheter aortic valve replacement (TAVI) outperformed surgical valve replacement in terms of a composite outcome of death, stroke, or rehospitalization in all-comer women with severe aortic stenosis. The less invasive TAVI treatment was also more beneficial concerning the use of healthcare resources, according to the RHEIA trial.

The RHEIA trial (NCT04160130) included women all comers with severe aortic stenosis to compare TAVI with surgery and confirm the benefit of TAVI over surgery in women. The 443 participants were randomly assigned 1:1 to TAVI or surgery and were tested for a primary composite endpoint of all-cause mortality, stroke, and rehospitalization after 1 year of follow-up.

The primary endpoint event rate was significantly higher in the surgery arm than in the TAVI arm (15.6% vs 8.9%; HR 0.55; 95% CI 0.34–0.88; log-rank P=0.03)¹. “The effect was driven by a reduction in hospitalizations in the TAVI arm [4.8% vs 11.4%; P=0.02],” explained Hélène Eltchaninoff, MD, PhD, from the University Hospital of Rouen, in France. “We also saw that the incidence of new-onset atrial fibrillation was seven times higher in the surgery arm than in the TAVI arm” (28.8% vs 3.3%; P<0.001). On the other hand, new permanent pacemakers were more common in the TAVI arm (8.8% vs 2.9%; P=0.01). Finally, participants in the TAVI arm had a shorter length of index hospital stay than participants in the surgery arm (median 4 vs 9 days).

“In women all-comers with severe aortic stenosis, TAVI was superior to surgery for the primary composite endpoint of death, stroke, or rehospitalization,” decided Prof. Eltchaninoff.

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