Bicuspid Aortic Valve dilemma: TAVI or SAVR? Insights from the NOTION-2 trial.
Pradeep NarayanPublished in: Indian journal of thoracic and cardiovascular surgery (2024)
The Nordic Aortic Valve Intervention-2 (NOTION-2) trial is the first randomized controlled trial to compare transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in low-risk patients, specifically focusing on relatively younger patients and those with bicuspid valves. It randomized 370 patients (mean age 71 years) to assess outcomes at 1 year. Results indicated a higher composite primary endpoint rate for TAVI (10.2%) compared to SAVR (7.1%) in the overall cohort, with even more pronounced differences in patients with bicuspid valves (14.3% for TAVI vs. 3.9% for SAVR). The risk of death or disabling stroke at 1 year was also three times higher with TAVI.
Keyphrases
- aortic valve
- transcatheter aortic valve implantation
- aortic valve replacement
- aortic stenosis
- ejection fraction
- transcatheter aortic valve replacement
- randomized controlled trial
- end stage renal disease
- newly diagnosed
- study protocol
- clinical trial
- chronic kidney disease
- peritoneal dialysis
- left ventricular
- prognostic factors
- coronary artery disease
- insulin resistance
- adipose tissue
- blood brain barrier