Temporal Trends in TAVR Utilization and Outcomes in Patients Younger Than 70 Years

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Summary of  Journal of the Society for Cardiovascular Angiography & Interventions https://doi.org/10.1016/j.jscai.2026.105752
Dr. Srinivasa Potluri et al.

Points

Baylor Scott and White Health researchers analyzed five thousand seven hundred fifty five aortic valve replacement procedures conducted over eleven years in patients younger than seventy.
Transcatheter aortic valve replacement annual procedures among patients under seventy increased nearly ninefold from fifteen in 2014 to one hundred thirty four in 2024.
Growth was primarily driven by patients aged sixty to sixty nine among whom annual transcatheter aortic valve replacement volume rose from fourteen to121 procedures.
Unadjusted clinical outcome comparisons demonstrated lower acute kidney injury rates and decreasing temporal bleeding complications following transcatheter aortic valve replacement compared to surgical intervention.
Authors concluded that while surgical replacement remains predominant overall transcatheter adoption in younger cohorts necessitates comprehensive heart team evaluations regarding lifetime valve durability.

Summary

This retrospective cohort study evaluated 11-year temporal trends and early clinical outcomes comparing transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients younger than 70 years. Simultaneously published in the Journal of the Society for Cardiovascular Angiography & Interventions and presented at TCT 2026, the investigation analyzed 5,755 total procedures across the Baylor Scott & White Health system from 2014 to 2024. Given that younger patients face lifelong considerations regarding bioprosthetic valve durability, structural valve deterioration, and repeat interventions, the research sought to characterize real-world procedural shifts and early safety metrics.

The cohort comprised 1,008 TAVR procedures and 4,747 SAVR procedures, establishing that SAVR remained the predominant treatment strategy across all evaluated age brackets. However, annual TAVR volume among patients younger than 70 increased nearly ninefold, rising from 15 procedures in 2014 to 134 in 2024. This growth was predominantly driven by individuals aged 60 to 69 years, in whom TAVR volume expanded from 14 to 121 annual cases, whereas utilization in patients under 60 remained limited. Unadjusted early outcome analyses indicated lower rates of acute kidney injury following TAVR compared to SAVR in age subgroups 50 to 59 and 60 to 69, with temporal declines in TAVR-associated acute kidney injury and bleeding, while 30-day mortality and stroke rates remained stable.

The authors conclude that TAVR utilization is expanding rapidly among younger, lower-risk cohorts, particularly those in their 60s. Because the unadjusted clinical comparison was purely descriptive without establishing comparative superiority or equivalence, the multidisciplinary heart team must emphasize lifetime management strategies, structural valve durability, and coronary access when selecting interventions for younger populations.

Link to the article: https://www.jscai.org/article/S2772-9303(26)01499-7/fulltext

References

Potluri, S., Narvaez-Calderon, M. F., Abo Hajar, M. B., Prasad, T., Daoud, R., Pavlovsky, E., DeVries, W., Gupta, S., Baig, I., Thomas, S., Harrington, K., Ejiofor, J., Brinkman, W., Al-Azizi, K., Aqtash, O., Schaffer, J. M., Mack, M. J., DiMaio, J. M., & Szerlip, M. (2026). Temporal trends in utilization and early outcomes of transcatheter versus surgical aortic valve replacement in patients younger than 70 years. Journal of the Society for Cardiovascular Angiography & Interventions, 105752. https://doi.org/10.1016/j.jscai.2026.105752