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The Latest in Management of Aortic Stenosis

Written by Bryan Heart cardiologist John Steuter, MD

The American College of Cardiology (ACC) held their 2019 Scientific Session this spring. One of the most talked-about sessions included findings from the PARTNER 3 and Evolut TAVR trials in low-risk patients.

TAVR and Partner 3

Evolut TAVR in Low-Risk Patients Trial

The Evolut Low-Risk trial tested the self-expanding CoreValve, Evolut R, and Evolut PRO (Medtronic) valves in a low-risk patient population. The 24-month estimated incidence of death or disabling stroke was similar in the TAVR and surgical arms, meeting the definition of statistical noninferiority but not superiority.

PARTNER 3 Trial

The PARTNER 3 trial, however, exceeded noninferiority expectations, with reports that treatment with the balloon-expandable Sapien 3 transcatheter heart valve (Edwards Lifesciences) was better than surgery for the prevention of death, stroke and rehospitalization at one year; the study’s primary endpoint.

Conclusions from the PARTNER 3 and Evolut TAVR Trials

Investigators concede that their results do not address the issue of long-term structural valve deterioration and both trials plan to follow patients for at least a decade. As well, prior TAVR studies in high risk and intermediate subset patients have not shown any signal of early valve failure. Most surgical valves haven’t been subjected to the same level of scrutiny facing transcatheter heart valves.

What’s Next?

The FDA is expected to rule on the indication for TAVR in low risk patients by the end the year - likely in the next couple of months.

At Bryan Heart we are pleased to offer these advanced options to our patients through our structural heart program.

Bryan Heart Structural Heart Program

Our structural heart team consists of cardiologists, cardiothoracic surgeons, advanced practice providers, imaging specialists and nurses. These team members will provide assessment and treatment options for discussion with you and your patients.

Meet our team, view areas of expertise and services included in the structural heart program.

If you have questions about the Bryan Heart Structural Heart Program or would like to refer a patient, call 402-483-3333.


Hearts and Huskers Fall Cardiology Conference

Saturday, August 31, 2019
7-10 a.m.
UNL Campus, Hawks Hall, College of Business

Learn from the region's leading heart and vascular experts and improve the continuity of care for your patients with the most current developments in cardiovascular care.

Get updates on:

  • Cardiac, thoracic and vascular surgery
  • Electrophysiology
  • Structural heart
  • Prevention
  • General cardiology
  • "Ask the Docs" panel

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steuter john

About John Steuter, MD

John Steuter, MD, is a cardiologist at Bryan Heart. Steuter is a graduate of The University of Nebraska Medical Center College of Medicine and joined Bryan Heart in 2015 after completing his residency and fellowship at The University of Nebraska Medical Center. He is certified with the American Board of Internal Medicine.

View Dr. Steuter’s physician profile

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