TAVI enthusiasm should be “tempered” in low-risk patients whilst durability concerns remain

Philippe Pibarot (Québec, Canada) talks to BLearning Cardio at PCR London Valves 2019 (17–19 November, 2019; London, UK) about the main data findings in the PARTNER 2 trial which evaluated more than 2,000 intermediate-risk patients with severe aortic stenosis who either underwent a TAVI procedure or surgical aortic valve replacement (SAVR). 

There were “no major red flags” from the data says Pibarot, who adds however, that that the SAPIEN XT (second generation device) had lower durability at five years compared to surgery which was “somewhat disappointing”. 

On the other hand, the third generation SAPIEN 3 showed similar durability to surgery at five years. He explains that although he was expecting greater durability in the third generation device, the amount of difference “surprised me”. Pibarot delves into why this was the case and looks at some of the main design differences between the two iterations.

Pibarot concludes by discussing the future of TAVI and the in particular the move to low-risk patients. He believes that physicians need to “temper our enthusiasm” of using TAVI in this patient group until there is “an established record for durability”.  

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Pibarot, Philippe

Philippe Pibarot is currently full professor at the Department of Medicine of Laval University, and director of the Research Group in Valvular Heart Diseases at the Québec Heart & Lung Institute. He holds the Canada Research Chair in Valvular Heart Disease.

He has published more than 200 articles and presented 190 invited conferences in the course of his career. He received the James Hogg Award from the Institute of Circulatory and Respiratory Health (2006), the André Dupont Award from the Club de Recherches Cliniques du Québec (2006), the Preventive Cardiology Award of Excellence from the Heart and Stroke Foundation of Québec and 4th International Conference on Preventive Cardiology (2007), the Annual Achievement Award of the Canadian Society of Echocardiography (2010), and the Research Achievement Award, Canadian Cardiovascular Society (2010).

He was the chair of the Scientific Program Committee of the Canadian Cardiovascular Congress (2010-2011) and he has been elected as member of the nucleus of the Working Group in Valvular heart Diseases of the European Society of Cardiology.

Philippe Pibarot was born in Toulon, France in 1964. He obtained a doctorate in veterinary medicine (DVM) in 1987 at the University Claude Bernard in Lyon, France. He obtained his PhD degree in biomedical sciences from the University of Montreal in April 1995.

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