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Evidence from the placement of aortic transcatheter valve (PARTNER) trial—can we just dismiss it?

  • Pradeep NarayanEmail author
INVITED EDITORIAL
  • 2 Downloads

In a recent review titled “TAVI—thick on technology but thin on evidence,” Dr. Sarkar has raised many pertinent issues related to the adoption of transcatheter aortic valve implantation (TAVI) in general and the placement of aortic transcatheter valve (PARTNER) trial in particular [1].

The review has to be lauded for highlighting some very important issues regarding lack of data transparency and publication bias and bringing forward the many clinical concerns with transcatheter aortic valve replacement (TAVR) or TAVI. However, some of the criticism is a little harsh, and for the benefit of the readership, the positives of the trial need to be stressed upon too.

One of the criticisms of the trial in the review was lack of any substantive differences between the inoperable (cohort B) and high-risk operable groups (cohort A), implying that the criteria to choose who was high risk and who was deemed inoperable was flawed. However, the inoperability was decided not just on clinical but also...

Notes

Compliance with ethical standards

Conflict of interest

The author declares no conflict of interest.

Ethical approval

The invited editorial does not mention any patient or patient details, and hence, formal ethical approval is not required.

References

  1. 1.
    Sarkar K. TAVI—thick on technology but thin on evidence. Indian J Thorac Cardiovasc Surg. 2018.  https://doi.org/10.1007/s12055-018-0731-2.
  2. 2.
    Smith CR, Leon MB, Mack MJ, PARTNER Trial Investigators, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364:2187–98.CrossRefGoogle Scholar
  3. 3.
    Leon MB, Smith CR, Mack M, PARTNER Trial Investigators, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597–607.CrossRefGoogle Scholar
  4. 4.
    Gutsche JT, Patel PA, Walsh EK, et al. New frontiers in aortic therapy: focus on current trials and devices in transcatheter aortic valve replacement. J Cardiothorac Vasc Anesth. 2015;29:536–41.CrossRefGoogle Scholar
  5. 5.
    Thourani VH, Kodali S, Makkar RR, et al. Transcatheter aortic valve replacement versus surgical valve replacement in intermediate-risk patients: a propensity score analysis. Lancet. 2016;387:2218–25.CrossRefGoogle Scholar

Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2019

Authors and Affiliations

  1. 1.Department of Cardiac SurgeryNH Rabindranath Tagore International Institute of Cardiac SciencesKolkataIndia

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