Efficacy and Safety of Transcatheter Aortic Valve Replacement in High-Risk Patients

Abstract

Introduction: Transcatheter aortic valve replacement (TAVR) is becoming a more minimally invasive approach than surgical aortic valve replacement (SAVR) for high-risk patients with severe symptomatic aortic stenosis, with good procedural and clinical results.

Objectives: To assess the effectiveness and safety of TAVR in high-risk patients with severe aortic stenosis who have symptoms.

Materials and Methods: A Cross-sectional study was carried out from June 2025 to November 2025 at the Peshawar Institute of Cardiology, Peshawar, Pakistan. A total of 120 patients with high-risk were randomly assigned equally to TAVR or SAVR. Procedural success, hospital stay, complications, mortality, and echocardiographic outcomes were evaluated.

Results: TAVR achieved a procedural success rate of 96.7% and SAVR 93.3%. TAVR had a substantial impact on hospital stay and major bleeding. There was a trend toward a lower rate of mortality and stroke with TAVR and a higher rate of permanent pacemaker implantation. TAVR also resulted in beneficial hemodynamic and functional outcomes.

Conclusions: TAVR was an effective and relatively safe procedure for high-risk patients, and recovery was quicker and major bleeding events were less frequent than with SAVR.